Seeing the same doctor could affect time to cancer diagnosis

Whether or not patients see the same GP could affect how quickly bowel and lung cancers are diagnosed, according to a Cancer Research UK study led by University of Bristol researchers published in the British Journal of General Practice today.

Symptoms of lung and bowel cancer tended to be picked up more quickly if patients consulted an unknown doctor than if they saw their usual GP, the University of Bristol researchers found.

But although seeing a known GP may slightly delay diagnosis, following-up new symptoms with the same doctor was found to result in a quicker diagnosis.

The findings highlight a need for more research to establish in what circumstances seeing a different doctor for possible cancer symptoms could potentially speed up the time to diagnosis.

Study leader, Dr Matthew Ridd, a GP and senior lecturer in primary care at the Centre for Academic Primary Care in the School of Social and Community Medicine at the University of Bristol, said: "These findings provide some evidence that GPs should follow up patients who present with potential cancer symptoms to make sure they receive a timely diagnosis. Interestingly, we also found that your regular doctor might not be the best person to spot those symptoms in the first place. So in some cases getting a second opinion from a different doctor could speed up the time to diagnosis.

"We looked at breast, bowel and lung cancer in this initial study, so further research is needed to investigate what effect seeing the same doctor has on the speed of diagnosis for different types of cancer, and for people whose symptoms turn out not to be related to an underlying cancer."

This study used data from the General Practice Research Database across a ten-year period from 2000 to 2009. Around 18,500 patients, with a diagnosis of breast, bowel or lung cancer, aged 40-years or older at diagnosis and with at least one year of medical data were included. Relevant cancer symptoms or signs were identified up to one year before diagnosis and this was compared to how often patients saw the same doctor up to two years before their diagnosis.

For bowel cancer, seeing the same doctor over the two years before diagnosis was linked to a longer time to diagnosis, although this was small with a maximum delay of around seven days. Whereas continuing to see the same doctor after worrying symptoms were spotted tended to get a diagnosis around 14 days quicker. For lung cancer patients, this was around 18 days. Seeing the same doctor either before or after experiencing potential cancer symptoms didn't seem to affect time to diagnosis for breast cancer, suggesting that the potential benefits may be restricted cancers that are harder to diagnose.

Dr Richard Roope, Cancer Research UK's GP expert, said: "Many people prefer to have a single family doctor, but these intriguing findings suggest that in some cases a fresh pair of eyes could be better at spotting early signs of cancer. Most GPs will only see eight or so new cancer cases a year, despite thousands of patients arriving with potential cancer symptoms, so anything that can be done to support GPs in diagnosing cancer earlier is worth pursuing."

Sara Hiom, director of early diagnosis at Cancer Research UK, said: "This study provides a useful insight into how seeing the same doctor could impact the time to cancer diagnosis. Any delay in getting a cancer diagnosed has the potential to impact the success of treatment so it's vital we do everything possible to help GPs refer patients with potential cancer symptoms without delay."