Primary care cancer toolkit
Early Diagnosis and Referral
Finding and treating cancer when it is at an early stage provides the best chance of effective treatment. For example, more than 9 out of 10 people will survive bowel cancer if diagnosed at stage 1, as opposed to just 4 out of 10 when diagnosed at stage 4.
Patients with signs and symptoms suggestive of cancer should be referred for investigation according to national and local guidelines. Current NICE guidelines for England, Wales and Northern Ireland recommend the threshold of 3% positive predictive value for suspected cancer pathway referrals. It is important to recognise that, at this threshold, most referrals for suspected cancer will not lead to a cancer diagnosis.
Professional
Diagnosis and Referral Guidance
Information
- NICE: Latest Guidelines for Suspected Cancer Recognition and Referral
- Healthcare Improvement Scotland: Scottish Guidelines for Suspected Cancer Referral
- Cancer Research UK: Summary of NICE Guidelines
- Cancer Research UK: Prevention bitesize videos
- BMJ: Summary of NICE Adult Referral Guidelines
- Cancer Research UK: Local Cancer Statistics – Understand and compare the latest cancer-related statistical information in your area across the UK
- Bowel screening in Wales – information about the Faecal Immunochemical Test (FIT)
Tools
- Early Diagnosis of Cancer RCGP e-learning module. - A free 30-minute e-learning module has been developed for GPs. This course highlights the importance of recognising cancer in its early stages and the essential role of the GP in identifying common delays
- Cancer Research UK: Suspected Cancer Recognition and Referral Interactive Desk Easel. – Resource to help implementation of the guidelines
- Cancer Research UK: Infographic - NICE Suspected Cancer Recognition and Referral Symptom Reference Guide
- QCancer 2017. – A patient centred risk assessment tool for use in primary practice (in addition to Hamilton's RAT) providing an overall risk of undiagnosed cancer, and takes into account risk factors and symptoms
- Cancer Mind Maps. - interactive reference tool for the NG12 NICE guidelines which aims to make the guidelines more accessible to health professionals
Cancer Site Specific Guidance
- RCGP: Brain Tumours in Children Toolkit. – Contains specific symptom recognition resources from the 'HeadSmart' campaign
- Cancer Research UK/BDA: Oral Cancer Recognition Toolkit
- Cancer Research UK/BAD – Skin Cancer Recognition Toolkit
Decision Support and Safety Netting
Cancer symptoms are complex and can be vague and non-specific. An increasing number of decision support tools have been developed to aid in assessing a person's risk. These are designed to be used as an adjunct to, and not a replacement for, clinical judgement and current guidance. It is important to remember that people at low risk still have a risk. Effective safety netting will help to bring those people back promptly if symptoms do not improve, or if new symptoms develop.