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NICE guidance to help primary care staff spot cancer earlier

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Harnessing the skills and experience of nurses could ensure many more people survive cancer, say nursing leaders following the publication of new guidance on diagnosing the disease.

The National Institute for Health Care Excellence said thousands of lives could be saved each year if healthcare professionals in primary care settings followed its updated guidelines on recognition and referral for suspected cancer .

“Practice nurses… can make a big difference when it comes to spotting the signs and identifying the common cancer symptoms”

Peter Carter

The revised guidance – launched today – aims to help GPs and nurses recognise the signs and symptoms of 37 different cancers early on and refer people for the right tests faster.

NICE has taken a new approach by focusing on the symptoms patients may report when seen by a GP or nurse, instead of organising the guidelines on a cancer by cancer basis.

It sets out clear tables linking signs and symptoms to possible cancers and includes simple recommendations on which tests to perform and referrals.

“The best way to successfully treat cancer is to make an early diagnosis. The sooner the disease is identified, the more likely treatment is to be effective,” said Professor Mark Baker, clinical practice director at NICE.

“This guideline is unique among guidance of this type, because it presents the evidence in the way patients present to their GPs,” he said. “It reflects real life and we expect it to have a major impact on the success rate for cancer in England.”

Dr Steve Hajioff, who chaired the independent group of experts that developed the guidance for NICE, said the resource should encourage clinicians to think about the possibility of cancer sooner.

“The purpose of this approach is to make it easier to use by primary care clinicians in a busy consulting room, so they don’t have to wade through documents,” he said.

“They can look very quickly at the information to help them make an appropriate decision and so potentially fewer things are missed,” he added.

“The purpose of this approach is to make it easier to use by primary care clinicians in a busy consulting room”

Steve Hajioff

The Royal College of Nursing said it was now up to health professionals to put the guidance into action.

“Practice nurses, as well as those working in the community, can make a big difference when it comes to spotting the signs and identifying the common cancer symptoms,” said RCN chief executive and general secretary Peter Carter.

“By harnessing their skills and experience, nurses can help to significantly boost faster diagnosis and survival rates,” he said.

“Primary care staff all have a responsibility to diagnose cancer patients more rapidly,” he said. “They need to incorporate this new guidance into their practice if they are to help prevent more needless deaths from cancer.”

Cancer charities, including Macmillan Cancer Support, welcomed the emphasis on early diagnosis but warned there could be “significant challenges” in implementing the guidance because some cancers, such as pancreatic cancer, could be very hard to spot.

The charity said it would also be updating its resources to support cancer diagnosis in primary care.

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