- Patients were sent away by doctors despite having ‘red flag’ symptoms
- Finding out at a late stage greatly reduces a patient’s chances of survivial
- 2,000 bowel cancer patients a year could have been diagnosed earlier
- Last year the health watchdog NICE issued GPs with a guide for spotting it
Sophie Borland Health Editor For The Daily Mail
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Family doctors are failing to diagnose thousands of patients who have one of the most common forms of cancer, research suggests.
A fifth of bowel cancer sufferers diagnosed in AE had previously been sent away by their GP despite having ‘red flag’ symptoms.
Patients who only find out they have the illness in casualty are far less likely to survive, as most have advanced stage tumours which are extremely difficult to treat.
The study by University College London and Cancer Research UK suggests GPs are routinely missing the typical signs of bowel cancer, which include weight loss and abdominal pain.
A fifth of bowel cancer sufferers diagnosed in AE had previously been sent away by their GP despite having ‘red flag’ symptoms (file image)
It suggests that at least 2,000 bowel cancer patients a year whose illnesses were picked up in AE could have been diagnosed earlier.
The study also found that women were far more likely than men to only have tumours picked up in AE. This may be because symptoms were confused by doctors and women with the menopause.
Britain has one of the worst cancer survival rates in Western Europe and this has partly been blamed on GPs missing warning signs.
There is also evidence that GPs are being deterred from referring patients for scans and tests because managers are trying to save money.
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About 41,000 men and women in Britain are diagnosed with bowel cancer a year and it causes 16,000 deaths. Rates have soared by 14 per cent since the 1970s partly due to obesity, diets rich in red meat and a lack of exercise.
The study, published in the British Journal of Cancer, looked at the records of 1,606 patients from 200 practices diagnosed with bowel cancer from 2005 to the present day.
It found that a fifth – 22 per cent – were only detected in AE, known as an ‘emergency presentation.’
And 20 per cent of these patients had seen their GP at least once in the past year with a red flag symptom, a typical sign of the illness.
DOCTORS TOLD ME I WAS JUST STRESSED
By Katie Strick For The Daily Mail
For nearly three years, student nurse Anna Flood went back and forth to her GP complaining of fatigue and indigestion
For nearly three years, student nurse Anna Flood went back and forth to her GP complaining of fatigue and indigestion.
The doctor was sympathetic but reassured her that the problem was not a disease, but simply stress.
Miss Flood, now 28, said: ‘I went with really bad shoulder pain, which subsequently, when I was in hospital, was thought that it might have been a side effect.
‘But it was at the time of my first visit that I started getting really tired, pale and anaemic. I didn’t really know what was going on.
‘I was doing a master’s and working in a museum so I was convinced for a while that my ill health was due to my busy life.’
Miss Flood, who lives in Bristol, went back to her GP repeatedly, but each time it was the same story. She said: ‘I was diagnosed with indigestion or irritable bowel — but always the underlying problem was my “stress”.
‘I bought over-the-counter iron tablets and tried to carry on.’
But her symptoms kept deteriorating and she would wake up in the night with agonising abdominal pain.
Then one morning in 2010, three years after her symptoms began, she fainted on the train to work.
Her mother decided enough was enough and drove her to AE.
There, a CT scan revealed a tumour in her large intestine and she had emergency surgery to remove a section of it as well as the end of her small intestine.
The cancer has taken a huge physical toll on her body, as her gut can no longer absorb vital nutrients.
She said: ‘If I’d had a simple blood test then it would have flagged up further screening that I could have done as to why I was anaemic and all these other symptoms.
‘If they’d asked me more questions about my lifestyle, about what sort of symptoms I was experiencing, why I was so tired, why I was so pale, I think it would have been investigated much quicker.’
Dr Cristina Renzi, a disease specialist at UCL, said: ‘We know that patients diagnosed with cancer after emergency presentations don’t do as well as patients who are diagnosed by their doctor through non-emergency routes.
‘This study highlights the need to support GPs and give them the tools to diagnose and refer patients promptly when they feel it’s necessary.’
Last year the health watchdog NICE issued GPs with a step-by-step guide to spotting cancer amid concerns too many cases were being missed. But doctors say managers are refusing to allow them to send patients for scans and X-rays over cost concerns.
A survey of 500 GPs earlier this year found that a third had tried to refer patients but were ‘blocked.’ Mark Flannagan, of the charity Beating Bowel Cancer, said: ‘If your GP does not initially refer you but your symptoms continue for three weeks or more, go back and ask for a referral for further tests.
Last year the health watchdog NICE issued GPs with a step-by-step guide to spotting cancer amid concerns too many cases were being missed
‘It’s important to find out if it could be something more serious so be persistent – it could save your life.’
Dr Richard Roope, of the Royal College of GPs, said: ‘Bowel cancer can be difficult to diagnose in primary care, particularly as many of its symptoms can be quite vague and could also indicate more common conditions.
‘Nevertheless, GPs are doing a good job of appropriately referring our patients that we suspect of having cancer – 75 per cent of patients found to have cancer are referred after only one or two GP consultations.’
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