Patients with ‘red flag’ cancer symptoms not being referred by their GP

Two in three patients with “red flag” cancer symptoms are not being referred by their GP for urgent investigation, a study claims.

One in every 28 patients not referred for tests on symptoms such as a breast lump, blood in urine or problems swallowing has gone on to be diagnosed with the disease, analysis of GP records found.

Patients aged 18 to 24 and those with coexisting conditions were less likely to be given an urgent referral.

Of the 29,045 patients not referred during the study period of 2014-15, 1,047 developed cancer within a year, according to the study of nearly 49,000 patient records led by the University of Exeter.

Lead author Dr Bianca Wiering said: “This could mean an opportunity to diagnose the cancer earlier was missed.”

One young mum diagnosed with bowel cancer claimed she was not urgently referred after she experienced bleeding because her GP thought she was too young to have the disease.

In a remote consultation while pregnant in March last year, Jenny Carter was told she had piles. The 37-year-old marketing worker of Hornchurch, Essex, was finally diagnosed with cancer after ordering a stool sampling kit – soon after her mother died from the same illness.

She said: “I started experiencing the same symptoms I knew all too well, like heavy bleeding, and called my GP multiple times to express my concerns.

“They said I was too young for bowel cancer despite my family history [and] without an internal examination.”

The NHS is trying to deal with a vast cancer treatment and diagnosis backlog which the Institute for Public Policy Research has estimated could take a decade to clear.

Dr Wiering added: “This issue does not just lie with GPs – we also need to ensure the services to provide the tests needed on referral are well resourced, which we know is currently not always the case.”

The NHS said: “The data referenced is from 2014-15. Since then, urgent GP referrals for suspected cancer have been rising at around 200,000 each year. The NHS has continued to prioritise cancer care throughout the pandemic.”

Prof Martin Marshall, of the Royal College of GPs, said: “GPs understand the importance of identifying cancer in a timely way. They are doing a good job of appropriately referring patients with 75% of those found to have cancer referred after only one or two consultations.”