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Rethinking diagnostic delay in cancer: how difficult is the diagnosis?


Type

Article

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Authors

Lyratzopoulos, Georgios  ORCID logo  https://orcid.org/0000-0002-2873-7421
Wardle, Jane 
Rubin, Greg 

Abstract

The timely diagnosis of cancer is a frequent theme in the lay press and an increasingly common topic for quality improvement initiatives.1 2 The UK’s health secretary has advocated ranking general practices on the NHS Choices website according to how promptly patients subsequently diagnosed with cancer are referred to specialist services for suspected cancer.3 But is such a policy based on evidence? Its main assumption is that the multiple visits made by these patients to primary care before referral chiefly reflect poor professional performance rather than factors such as clinical complexity, reasonable watchful waiting, or the need for appropriate investigations in primary care. We review the occurrence of multiple pre-referral consultations and discuss how a better understanding of variation between cancers might improve the timeliness of diagnosis.

Description

Keywords

Biomedical Research, Delayed Diagnosis, General Practice, Health Policy, Humans, Neoplasms, Primary Health Care, Referral and Consultation, Time Factors, United Kingdom, United States

Journal Title

BMJ

Conference Name

Journal ISSN

0959-8146
1756-1833

Volume Title

349

Publisher

BMJ
Sponsorship
TCC (None)
GL is supported by a postdoctoral fellowship award from the National Institute for Health Research 2012-14 (PDF-2011-04-047). JW is supported by Cancer Research UK. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health, or any other organisation.