Reducing diagnostic delay for better cancer outcomes

Richard Neal, MB, ChB, PhD, FRCGP, from the Leeds Institute of Health Sciences, Leeds, UK, discusses his talk on reducing diagnostic delay for better cancer outcomes, which he presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He describes that early diagnosis is associated with better cancer outcomes, and suggests that health care systems with a slower diagnosis process can learn from countries with faster diagnosis, resulting in better outcomes. Prof. Neal highlights three ways in which earlier diagnosis can be achieved. Firstly, patients should be encouraged to visit their healthcare practitioner when they display certain symptoms, such as coughing for three week. He points out the effectiveness of awareness campaigns in achieving short- and medium-term benefit, as these campaigns both educate about symptoms and indicate what should be done by the patient, but argues that awareness campaigns must be improved to derive long-term benefit, so that patients presenting with symptoms quickly access primary care services. Secondly, Prof. Neal talks about how the behavior of primary care practitioners can be changed to form a safety net, such as telling patients that they should return if they develop an additional symptom, as most cancers begin with symptoms which are common, for example stomach pain. Primary care practitioners should use decision support tools to enable effective identification of patients at risk of undiagnosed cancer, taking into account symptoms, risk factors, age, and patient group. Harnessing this technology will also allow them to work more efficiently. Finally, better tests need to be available and accessible to primary care practitioners to enable cancer diagnosis.
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