Cancer outcomes linked to GP referral rates

June 26, 2013
Cancer outcomes linked to GP referral rates

(Medical Xpress)—Patients from GP practices with low endoscopy referral rates are at increased risk of poor outcomes from oesophageal and gastric cancers, according to research at the University of Liverpool.

Research, presented at Public Health England's National Cancer Intelligence Network annual conference, showed that there is a wide variation in rates of elective endoscopy between GP practices across England.

Variation in average referral rates

An endoscopy is a medical procedure during which a thin, flexible tube called an endoscope is used to look inside the stomach. It can be used to investigate conditions of the throat and gut.

The team studied more than 22,000 new cases of oesophageal and gastric cancer from over 6,000 general practices. Their research showed that average referral rates for endoscopy varied by 250%

Patients belonging to practices with low rates of endoscopy referral were shown to be at increased risk of a poor outcome as reflected in higher rates of emergency admission for diagnosis, lower rates of potentially curative surgery and poorer one year survival rates.

This was most marked in practices serving deprived populations where those in the low referring group had the poorest cancer outcomes in the country.

Dr Keith Bodger, at the University's Institute of Translational Medicine and Consultant Gastroenterologist at Aintree University Hospital, said: "Most tumours of the oesophagus or stomach are incurable by the time of diagnosis in the UK. Early symptoms may be mild or indistinguishable from the common benign causes of indigestion.

"Current NICE guidelines advise a conservative approach to investigating stomach symptoms, reserving gastroscopy for older patients or those with established 'red flag' or 'alarm' symptoms.

"Our research shows that general practices in England vary substantially in their rates of gastroscopy and that low rates are associated with a risk of poorer outcomes for oesophageal and .

Targeted interventions

"Targeted interventions may be required for local populations having inappropriately low rates of investigation to encourage older people at risk to seek medical advice and to provide GPs with revised, more flexible guidelines and good local access to investigations."

Outcomes for many cancers have improved over the last decade, but progress has been limited for tumours of the oesophagus and stomach. One year for these cancers are approximately 40%.

The research recommends that GP practices with low rates of endoscopy referral should review their current practice, particularly those serving deprived populations.

Explore further: 700 women with urinary cancers in England missing out on prompt diagnosis every year

Related Stories

700 women with urinary cancers in England missing out on prompt diagnosis every year

June 24, 2013
Around 700 women in England with symptoms of kidney or bladder cancer are missing out on prompt diagnosis and treatment of their condition every year, reveals research in the online only journal BMJ Open.

Wide variation in number of patients GPs refer with suspected cancer

July 31, 2012
Information published today by the National Cancer Intelligence Network (NCIN) reveals wide variation across England in the numbers of patients with suspected cancer that GP practices refer to secondary care.

A quiet epidemic: Men's risk of oesophageal cancer is triple women's risk

June 18, 2013
(Medical Xpress)—Men are almost three times more likely to get oesophageal cancer than women – one of the biggest gender gaps in cancer rates – according to figures released from Cancer Research UK.

More accident and emergency visits where access to GPs is worse

June 12, 2013
Patients with more timely access to GP appointments make fewer visits to accident and emergency departments, suggests a study published today.

Bowel, oesophageal and pancreatic cancers show biggest improvement in diagnosis time

November 8, 2011
(Medical Xpress) -- New research shows that bowel, oesophageal and pancreatic cancers have seen the greatest improvement in the time it takes from when a patient first visits their GP with symptoms to when they are diagnosed ...

'Sponge on a string' trial launched to try and prevent deadly oesophageal cancer

October 14, 2011
(Medical Xpress) -- Cancer Research UK has launched a large multi-centre trial to test a new device for detecting Barrett’s oesophagus – a condition that puts sufferers at increased risk of developing cancer of ...

Recommended for you

New therapeutic approach for difficult-to-treat subtype of ovarian cancer identified

July 24, 2017
A potential new therapeutic strategy for a difficult-to-treat form of ovarian cancer has been discovered by Wistar scientists. The findings were published online in Nature Cell Biology.

Immune cells the missing ingredient in new bladder cancer treatment

July 24, 2017
New research offers a possible explanation for why a new type of cancer treatment hasn't been working as expected against bladder cancer.

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.