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Cancer referral 'confusing' GPs Cancer referral 'confusing' GPs
(30 minutes later)
Many GPs do not know how to deal with women who are worried they may have breast cancer, a survey has suggested.Many GPs do not know how to deal with women who are worried they may have breast cancer, a survey has suggested.
Breakthrough Breast Cancer found confusion about when to refer people as urgent cases rather than routine ones.Breakthrough Breast Cancer found confusion about when to refer people as urgent cases rather than routine ones.
Its survey of 200 GPs for BBC Radio 4's Today also suggested few GPs initiated conversations about breast cancer or offered screening to at-risk groups.Its survey of 200 GPs for BBC Radio 4's Today also suggested few GPs initiated conversations about breast cancer or offered screening to at-risk groups.
The British Medical Association said unnecessarily treating cases as urgent would put hospitals under pressure.The British Medical Association said unnecessarily treating cases as urgent would put hospitals under pressure.
GuidelinesGuidelines
The survey showed that while most GPs followed guidelines set out by the National Institute for Health and Clinical Excellence (NICE) on breast cancer referrals, some were confused about when to treat them as routine or urgent.The survey showed that while most GPs followed guidelines set out by the National Institute for Health and Clinical Excellence (NICE) on breast cancer referrals, some were confused about when to treat them as routine or urgent.
It found 10% of GPs would refer a woman who had previously had confirmed breast cancer routinely, when NICE guidelines state she should be seen urgently.It found 10% of GPs would refer a woman who had previously had confirmed breast cancer routinely, when NICE guidelines state she should be seen urgently.
GPs and Primary Care Trusts have a key role in helping women understand the benefits of breast awareness and breast screening Jeremy HughesBreakthrough Breast CancerGPs and Primary Care Trusts have a key role in helping women understand the benefits of breast awareness and breast screening Jeremy HughesBreakthrough Breast Cancer
In addition, the study suggested 34% of family doctors would refer routinely a female patient aged under 30 who had reported a lump and had reasons for concern, such as a family history of the disease, when NICE advises such a case should be treated as urgent. In addition, the study said 34% of family doctors would refer routinely a female patient aged under 30 who had reported a lump and had reasons for concern, such as a family history of the disease, when NICE advises such a case should be treated as urgent.
Jeremy Hughes, chief executive of Breakthrough Breast Cancer, said it was "surprising" that all GPs were not sufficiently aware of the risks of breast cancer and how urgently cases should be dealt with.Jeremy Hughes, chief executive of Breakthrough Breast Cancer, said it was "surprising" that all GPs were not sufficiently aware of the risks of breast cancer and how urgently cases should be dealt with.
"If you go to your GP and the GP says 'well there may be something of concern here [but] it may not be very important' you don't go away and forget about it, you go away and worry.""If you go to your GP and the GP says 'well there may be something of concern here [but] it may not be very important' you don't go away and forget about it, you go away and worry."
He acknowledged the government's pledge to ensure all patients referred to a specialist are seen within a fortnight, but said any waiting time for women was "extremely stressful" and the target needed to be reached as soon as possible. The Department of Health said: "Over 99% of patients with suspected cancer are now seen by a specialist within two weeks of being referred by their GP."
By December 2009, all women referred to a specialist with breast symptoms - even if cancer is not suspected - would be seen within a fortnight, a spokesman said.
The British Medical Association said GPs were not confused about how to handle breast cancer.The British Medical Association said GPs were not confused about how to handle breast cancer.
"Of course, it's better to refer urgently if you suspect or even wonder if a patient has breast cancer," said Dr Laurence Buckman. "But very often women with breast disease do not have cancer, and clearly not."Of course, it's better to refer urgently if you suspect or even wonder if a patient has breast cancer," said Dr Laurence Buckman. "But very often women with breast disease do not have cancer, and clearly not.
"They should not be lumped together with urgent cases because what will happen is if everyone is made an urgent case there will not be enough time in outpatients.""They should not be lumped together with urgent cases because what will happen is if everyone is made an urgent case there will not be enough time in outpatients."
Survival ratesSurvival rates
The survey also found that most of the GPs questioned were not proactively promoting breast cancer awareness and screening to their patients aged over 50 - one of the most at-risk groups.The survey also found that most of the GPs questioned were not proactively promoting breast cancer awareness and screening to their patients aged over 50 - one of the most at-risk groups.
Only 16% of family doctors said they spoke to older women about the disease and its symptoms whenever they had an appointment, while 80% said they did so only when asked by a patient.Only 16% of family doctors said they spoke to older women about the disease and its symptoms whenever they had an appointment, while 80% said they did so only when asked by a patient.
Experts want GPs to increase awareness of breast cancerExperts want GPs to increase awareness of breast cancer
According to Breakthrough Breast Cancer, although UK survival rates have improved in recent years, they are still lower than in the US and many other European countries.According to Breakthrough Breast Cancer, although UK survival rates have improved in recent years, they are still lower than in the US and many other European countries.
The risk of death in the first six months after diagnosis remains higher in the UK than in the rest of Europe.The risk of death in the first six months after diagnosis remains higher in the UK than in the rest of Europe.
Mr Hughes said this showed "a real need for education about the signs and symptoms of the disease and breast screening".Mr Hughes said this showed "a real need for education about the signs and symptoms of the disease and breast screening".
"GPs and Primary Care Trusts have a key role in helping women understand the benefits of breast awareness and breast screening," he added."GPs and Primary Care Trusts have a key role in helping women understand the benefits of breast awareness and breast screening," he added.
Earlier this year, the charity also found widespread confusion among women about the signs of breast cancer.Earlier this year, the charity also found widespread confusion among women about the signs of breast cancer.
Its survey of 1,190 women over 50 found a quarter wrongly thought a persistent cough was a sign of breast cancer.Its survey of 1,190 women over 50 found a quarter wrongly thought a persistent cough was a sign of breast cancer.
Some 81% wrongly believed a mole on the breast could be a symptom, while a third incorrectly linked an extra nipple to the disease.Some 81% wrongly believed a mole on the breast could be a symptom, while a third incorrectly linked an extra nipple to the disease.