Australian GPs lead the way with early referrals for suspected cancer patients

Doctors in Victoria and New South Wales are more likely to immediately refer people with possible cancer for tests or to a specialist than those in comparable countries, new research published in BMJ Open has revealed.

The research - undertaken by a collaboration of six countries (International Cancer Benchmarking Partnership - ICBP), and which included the University of Melbourne - shows a link between a country's cancer survival and how likely that country's GPs were to refer patients immediately. Australian GPs were consistently among the most likely to refer quickly.

The Victorian-based tranche of the research was funded by the Cancer Council of Victoria and the Victorian Department of Health and Human Services.

Earlier ICBP research revealed cancer survival is highest in Australia, Canada and Sweden; intermediate in Norway; and lower in Denmark, England, Northern Ireland and Wales. And the latest ICBP research reveals striking new evidence for a possible explanation of these international survival differences.

Researchers analysed survey responses from 2795 GPs on how they would manage different scenarios of patients coming to them with possible cases of either lung, colorectal or ovarian cancer. These were then mapped against survival data for those countries. GPs were then asked a series of questions including what access they had to specific tests, waiting times for tests and results and whether they could speak to cancer specialists for advice. Almost every GP in Victoria reported direct access to blood tests, X-rays and ultrasound for possible cancer diagnosis (99%) – higher than any other jurisdiction.

Similarly, almost every GP in Victoria and New South Wales reported having direct access to CT and MRI scans – at least twice the level of direct access their peers in other countries reported having. GPs in Australia also reported dramatically shorter waiting times for the results of CT, MRI and ultrasound scans compared to all other countries (with a total waiting time of around one and a half weeks). In comparison, Northern Ireland had the longest waiting times for tests and results of ultrasound and CT scans (seven to eight weeks).

Paper co-author Associate Professor Marie Pirotta from the University of Melbourne said: "These striking findings are the first to identify how important the role is that GPs play in overall cancer outcomes. GPs have a difficult job to do. Many common symptoms may be due to an underlying cancer. GPs have to weigh up probabilities and ensure those who need tests or referrals to specialists get them, without overloading the health system."

"In Australia we are lucky our health system is delivering better cancer outcomes than in comparable countries overseas, and we must ensure the right support and resources remain in place so that doesn't change," Pirotta said.

Cancer Council Victoria CEO Todd Harper said: "A health system that allows GPs to refer people when and if they suspect cancer is vital to ensure early diagnosis and access to the best treatments. Cancer Council is working with GPs as well as state and national-decision makers to provide data, resources and training so that GPs refer the right patients at the right time and people with cancer are diagnosed and treated as quickly and efficiently as possible."