In a bid to speed up early cancer diagnoses, the National Institute for Health and Care Excellence (NICE) has recently recommended GPs in UK be given direct access to diagnostic tests for cancer, which include ultrasound, diagnostic endoscopy, magnetic resonance imagining (MRI) and computed tomography (CT).
The new recommendation’s aim is to diagnose cancer at an early stage when it is still curable. Professor Gillian Leng, deputy chief executive of NICE, said, “Speeding up diagnosis is a simple step that has the potential to save thousands of lives each year.”
Cancer is a colossal challenge. Currently, there are 1.8 million people living with cancer in the UK with one in three people in England likely to develop cancer in their lifetime. Of all cancer types, breast, prostate, lung and colon cancers are the most prevalent in the country, accounting for over half (53%) of all new cases.
Cancer incidence is ever-increasing, i.e., by 2030, the number of new cases is expected to jump well over 383,000 (i.e., 3 million) per year. Apart from taking a heavy toll on the patient’s physical and mental health, cancer is both crippling and expensive to treat. Although the overall cost of cancer care across the UK is £9.4 billion, a low-stage diagnosis is linked to larger cost savings.
In the new quality standards recently published in BMJ, NICE attempts to give GPs and primary care establishments the ability to refer patients directly for key screening and diagnostic tests for suspected cancer, so that the entire process can be accelerated. If diagnosed and treated early, more than 42% of cancers in the UK can be prevented.
The idea of GPs having direct access has been touted for a number of years. In fact, the Department of Health published guidelines regarding the issue in 2012. Yet there is evidence that GPs either lacked a direct access to or do not willingly order these diagnostic tests. An investigation by GP magazine in 2014 showed that as many as half of GPs were being denied direct access to tests.
This time, however, the recommendations are forceful, originate from a formidable health center and provide GPs with a greater freedom to investigate potential cases of cancer. The new recommendations are in tandem with the guidance published last year.
The main purpose of the recommendations is to investigate whether direct referral will result in cancer being diagnosed faster than traditional pathways. NICE further urges that people with suspected esophageal or gastrointestinal carcinoma must have direct access to diagnostic tests.
NICE believes GPs should be able to refer any patient aged 55 and above with symptoms suggestive of digestive tract cancer, i.e., upper abdominal pain, dysphagia, and reflux, for gastrointestinal endoscopy. The test should be performed promptly and the results should be sent back to the GP within two weeks.
An upper gastrointestinal endoscopy is a procedure that allows the doctor to view the inside of your esophagus and stomach with a camera-fitted probe called an endoscope.
The latest recommendations from NICE also stipulate that individuals with suspected colorectal cancer who do not otherwise meet the criteria for cancer should have a test for blood in their feces.
Moreover, NHS recently announced a new £15 million investment to speed up cancer diagnosis including a “national diagnostics capacity fund” to facilitate and upgrade diagnostic services. The investment will help establish and trial new multidisciplinary diagnostic centers over the next two years.