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Four out of 10 cancer patients initially misdiagnosed, finds report warning of pressures in testing

'The GP didn’t offer to refer at all, she was very clear she wasn’t concerned,' says Beth Purvis who was only diagnosed after a trip to A&E two years after she first had symptoms.

Alex Matthews-King
Health Correspondent
Tuesday 04 December 2018 08:15 GMT
Four out of 10 cancer patients initially misdiagnosed, finds report warning of pressures in testing

Four out of ten people with cancer in the UK are misdiagnosed at least once before their disease is identified, according to a report calling for more investment in early testing.

The report, by the All.Can cancer initiative, warns that one in five (21 per cent) of UK patients surveyed said they waited more than six months to get the correct diagnosis.

This failure to provide a quick, accurate diagnosis is costing patients their lives and the NHS money, the group warns.

Though the NHS and government have targeted earlier diagnosis, successive reports have found the UK is lagging behind other nations, with too many cancers being caught after they’ve already spread.

Beth Purvis, 39, from Essex, is one of the many patients whose symptoms were misdiagnosed and only picked up much later.

She went to her GP in 2014 after noticing rectal bleeding and changes in her bowel movements.

Her doctor told her that “a bit of IBS” was responsible, but unless her symptoms became debilitating and interfered with her work then there was not any treatment to offer.

“Tests were never mentioned,” she told The Independent, and while she recognised that her young age was a factor in her GP not immediately suspecting something serious, she believed more tests should have been done when her symptoms persisted.

“In 2016 I ended up in A&E with what I thought was rectal prolapse – but it turned out to be the cancer.”

Beth Purvis was diagnosed with bowel cancer after going to A&E in 2016, two years after her symptoms were written off as IBS

Last year, Cancer Research UK warned that 22 per cent of the 356,000 people diagnosed with cancer each year were only picked up at A&E.

In 71 per cent of these cases they had visited their GP at least once with symptoms linked to their cancer, meaning that opportunities to catch the disease early and minimise its spread had been missed.

In Ms Purvis's case, it took another three months before a full colonoscopy and the removal of a polyp in her colon led to her final diagnosis.

She underwent operations to remove the affected section of bowel and 12 rounds of chemotherapy, but a scan in November 2017 revealed the disease had spread.

“I had 10 nodules across both lungs and at the time I was told it was inoperable and incurable,” she told The Independent.

While they have since cleared the nodules from her lungs, the doctors have been clear that they expect the cancer to return and she is having regular check ups.

But speaking to The Independent before the school run, Ms Purvis is pragmatic about how her route to diagnosis could have gone differently and what could have been done better.

“The faecal test may have picked it up – but there’s no guarantees," she said. "A blood test is unlikely to have picked it up … the only real test for colon cancer is a colonoscopy.

“She [the GP] didn’t offer to refer at all, she was very clear she wasn’t concerned. I think it was a lack of education, but I suspect they’re time pressured themselves and I suspect they’re aware that the diagnostic facilities are under pressure.

“There is a lack of endoscopists at the moment. It’s a national shortage, so even people who are being referred are struggling to get a colonoscopy in some parts of the country."

A 2015 NHS England and CRUK joint report warned of significant pressure in cancer diagnostic services. Despite a 2011 government pledge of £450m for improving early diagnosis by allowing GPs to access key tests directly, CRUK warned that much of that funding was absorbed through financial pressures elsewhere in the cash-strapped NHS.

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While the NHS adopted a target of diagnosing 95 per cent of cancers within a month of a GP referral by 2020, these shortages pose a significant barrier to achieving it.

Ms Purvis told The Independent this is where she would like to see any future investment for cancer services targeted.

“I don’t think you’ll ever have a perfect system,” she said. “Unfortunately, people present with all sorts of different symptoms and annoyingly those can be attributed to lots of different diseases.

"So just improving diagnostics, more staff in endoscopy, radiology and more smaller testing from the GP surgery would be really good to see.”

The All.Can project is made up of international cancer experts, patient groups, policy makers and drug companies, and will be producing surveying cancer patients in 11 different countries as part of it’s review.

The findings from its first survey, of 322 UK cancer patients, are being presented at the Britain Against Cancer Conference in London on Tuesday.

“A quick and accurate diagnosis is essential if patients are to receive treatment that gives them the best chance of surviving cancer,” said Rachel Power, chief executive of the Patients Association, which chairs All.Can UK. “Only by working together to identify examples of waste and inefficiency in cancer care can we increase efficiency, improve outcomes and save lives.”

NHS England said it had invested an extra £200m on transforming cancer care and was rolling out mobile diagnostic units in supermarket carparks and other sites around the country.

“The NHS is now seeing 2 million urgent GP referrals a year, half a million more than in 2015 when NICE updated their referral criteria, with a record numbers of people receiving treatment,” a spokesperson said.

“Cancer survival rates are now at their highest ever and further work to ensure faster and earlier diagnosis – including the testing of new faster diagnosis where patients receive results within 28 days – is well under way.”

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