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Urgent GP referral variations reflect different levels of care

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Wide variation exists across England in the numbers of patients referred to hospital specialists by GPs for suspected cancer, according to new figures.

Data from the National Cancer Intelligence Network (NCIN) has shown a more than threefold difference in the rate of urgent GP referrals to hospital for patients with suspected cancer, from under 830 to more than 2,550 in every 100,000 patients a year.

The figures also showed a wide gap in the proportion of those patients referred who then go on to be diagnosed with cancer.

The network, set up in 2008 to promote the analysis and publication of cancer statistics, said the number of people referred by GPs was not on its own an indicator of how good they are at spotting the early signs of cancer.

But it said that the range of the variation was so wide that, at the extremes, it probably reflected differing standards of care.

Dr Mick Peake, clinical lead for the NCIN, said: “The data are not easy to interpret since we do not know what the ‘optimum’ level is for these measures and although the data are adjusted for age, there may be other differences in the characteristics of the patients of a particular GP practice that impact on local referral rates.

“However, the range of the variation is so wide that, at the extremes, it probably reflects differing standards of care.”

The charity Cancer Research UK said the more than threefold variation in the rate of urgent cancer referrals was “very worrying” as it suggested differing approaches by some GPs.

Sarah Woolnough, executive director of policy and information at Cancer Research UK, said: “It’s very worrying to see a more than threefold variation in the rate of urgent cancer referrals among GPs.

“Although the number of people GPs suspect have cancer and send for further tests will naturally vary depending on the age and demographic of their patients, this level of variation suggests differing approaches by some GPs.

“We urgently need to learn more about what’s behind these differences and tackle any poor practice.

“We already know that some patients present several times with cancer symptoms before being referred for further investigation, which can lead to late diagnosis.

“A delayed cancer diagnosis could prove critical for a patient’s chance of survival.”

Patients will be able to look up figures on cancer for their GP practice for the first time including the number of cancers diagnosed at the practice, the number of people who have screening and the numbers sent through the two-week wait referral system.

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