GPs are to refer suspected cancer patients for tests in a week under new scheme

Prime Minister Gordon Brown is expected to announce that by 2014 all patients with suspected cancer will undergo key diagnostic tests within one week.

A report in the Guardian newspaper said that up to 10 000 lives a year could be saved by the new initiative, which will see GPs being given the authority to directly refer patients to diagnostic services (www.guardian.co.uk, 26 Sep, “Gordon Brown to woo conference with cancer pledge and new NHS cash”).

Mr Brown’s speech was not released before he delivered it to the Labour party conference on Tuesday afternoon, as the BMJ went to press.

New imaging equipment is expected to be purchased, with funding coming from budget savings in other areas of the health service. The scheme is being seen as an extension of the government’s previous announcement that targets are to be replaced with a system of “patient entitlements.”

Harpal Kumar, chief executive at Cancer Research UK, said that faster access to diagnostic tests would help the United Kingdom to fix its “cancer problem” and raise its low cancer survival rates in comparison with the rest of Europe.

“If we can detect cancer early it usually makes successful treatment more likely. And if the problem turns out not to be cancer, early tests help to put patients’ minds at rest,” he said. But he warned that the announcement did not go far enough. “This is just one part of an approach needed to overcome the deficit in cancer survival in this country that is driven by late diagnosis. We would like to see more government investment in public awareness campaigns and thought given to extending cancer screening programmes, among a range of other measures,” said Mr Kumar.

Steve Field, chairman of the Royal College of General Practitioners, said that the existing two weeks for referral to a specialist had already made a difference for patients with suspected cancer. “But GPs would welcome the opportunity to refer patients directly for diagnostics such as magnetic resonance imaging and computed tomography scans, ultrasound, and flexible sigmoidoscopy without having to refer to a specialist first,” he said.

“This could prove to be one of the most important breakthroughs for general practice and represents a major vote of confidence in the ability and professionalism of GPs who for too long have been dismissed as the poor relation of our specialist colleagues.”

The announcement was also welcomed by many doctors providing cancer diagnosis services.

Andy Adam, president of the Royal College of Radiologists, said that investment in earlier detection would be beneficial. “Such early detection is so often the key to effective treatment, and diagnostic imaging plays a crucial role in this field,” he said.

However, the Royal College of Pathologists objected to some of the details, saying in a statement that Mr Brown has not gone far enough.

It said, “He has said that this will involve more ‘ultrasounds, CT, and MRI scans,’ but it is important to recognise that in almost every case the confirmation of cancer is made not by a scan but by a pathologist examining a tissue sample in the laboratory. Laboratory investigation is also essential to determine the type of cancer. So more scanning and more endoscopy is not a complete answer; the diagnosis is not certain, and treatment cannot be planned, until the laboratory tests are also complete.”