I agree with William Hamilton that strategies to detect cancer should aim for evidence-based efficiency, and that more of the evidence should come from community-based research. His commentary is a thoughtful discussion of ways of improving cancer diagnosis in the context of current strategies of the British NHS.1 But the scaffolding of the argument puzzled me: I recognise none of the five misconceptions that he argues are impeding progress in improving cancer diagnostic services. And so, in the spirit of friendly debate, I offer my contrarian perceptions of Hamilton's misconceptions.
Misconception 1: ‘cancer is diagnosed in hospitals’
This doesn't mean much to me as a concept — the familiar pathway to cancer diagnosis that Hamilton describes looks like a reasonably rational team-based approach to achieving the answers the patient needs. …