http://www.rcgp.org.uk/clinical/clinical-resources/~/media/Files/CIRC/Cancer/Improving%20Cancer%20Diagnosis%20-%20A%20Toolkit%20for%20General%20Practice%20(2).ashx

“Most patients were referred within one month of first
presentation (68%); 40% were referred at or following the initial consultation”

http://www.ncin.org.uk/publications/data_briefings/gp_referral_rates

“It is important to emphasise that there is no “right” or “wrong” level of referral. At present, work is being undertaken to understand the reasons for this variation.”

http://www.cancerresearchuk.org/cancer-info/spotcancerearly/naedi/beclearoncancer/lung/informationforgps/information-for-gps

“approximately 5% of all primary care consultations are for cough and 1.5% of the population consult with their GP for fatigue each year. However, a GP would typically expect to encounter a new lung cancer approximately once every 8 months^1″

http://www.bmj.com/content/334/7602/1013

“In the United Kingdom, a GP with a list size of 1500 will on average see only 1.39 cases of lung cancer, 0.23 oesophageal cancers, 0.99 colorectal cancers, and 0.45 renal or bladder cancers each year.”

http://thorax.bmj.com/content/61/11/975.abstract

“The prevalence of chronic cough was 12%, and was severe in 7%.”

http://www.ncbi.nlm.nih.gov/pubmed/16882373

“Thus, 38 of 164 patients (23%; 95% confidence interval = 16 to 32%) had a negative X-ray”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814263/

“However, specialist clinics are quick to criticise GPs for their failure to comply with referral guidance, while simultaneously stating that referral guidance has a very poor ability to identify cancer.3 This inconsistency leaves the GP in the middle, balancing patient expectations against the need to use resources appropriately”

http://www.nice.org.uk/guidance/CG27/chapter/1-Guidance#lower-gastrointestinal-cancer

“In patients aged 40 years and older, reporting rectal bleeding with a change of bowel habit towards looser stools and/or increased stool frequency persisting for 6 weeks or more, an urgent referral should be made.

In patients aged 60 years and older, with rectal bleeding persisting for 6 weeks or more without a change in bowel habit and without anal symptoms, an urgent referral should be made.”

Ca -125 use

Same-day hubs are a ‘national imperative’, claims under fire ICB

GP requests for CA125 testing in women with symptoms of ovarian cancer have soared by nearly 200%, but the rise is warranted as around one in ten of those with high levels are subsequently diagnosed with malignancy, show UK researchers.

http://www.nice.org.uk/guidance/cg122/resources/cg122-ovarian-cancer-full-guideline3

statins

http://www.bmj.com/content/348/bmj.g3306/

http://www.bmj.com/content/348/bmj.g3306/rapid-responses

“Putting approximately five million more people in the UK on drugs, that will then have to be taken lifelong, for primary prevention of CVD without knowing enough about the side effects is foolhardy. The data on side effects needs to be made public and scrutinised by well qualified independent assessors. ” Klim McPherson

http://annals.org/article.aspx?articleid=1671715

“Statins were discontinued at least temporarily for 57 292 of 107 835 patients. Statin-related events were documented for 18 778 (17.4%) patients. Of these, 11 124 had statins discontinued at least temporarily; 6579 were rechallenged with a statin over the subsequent 12 months. Most patients who were rechallenged (92.2%) were still taking a statin 12 months after the statin-related event. Among the 2721 patients who were rechallenged with the same statin to which they had a statin-related event, 1295 were receiving the same statin 12 months later, and 996 of them were receiving the same or a higher dose.”

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673612603675.pdf?id=caam23il1u7uv9plFtXBu

plos

– On unreported outcomes

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001526

continuity of care and cancer diagnosis

http://jrs.sagepub.com/content/106/11/437.full.pdf+html