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Today the National Institute of Health and Care Excellence has produced new draft guidelines for GPs on referring patients with possible suspected cancer. The guidelines will be consulted on and, when in force, will be used by GPs in England, Wales and Northern Ireland. Scotland updated its own referral guidelines for Scottish GPs earlier this year, and you can see our – largely positive – comments on them here.

Whilst we will need some time  to work our way through the bulky consultation documents, we welcome the fact that updated cancer referral guidelines are being introduced.  We also welcome the fact that many of the proposals in the consultation document reinforce recommendations  arising from Pancreatic Cancer UK’s own Early Diagnosis 2012 Summit Report.

We have long argued that these are necessary, as clearer and more robust GP referral guidelines will help enable earlier diagnosis of pancreatic cancer. Enabling earlier diagnosis is especially important for pancreatic cancer patients as, currently, nearly half of all diagnoses are made via the emergency admission route and we know that patients diagnosed via emergency admission  have much worse survival outcomes than those diagnosed via routine GP referral.  

Put simply, better GP referral guidelines could help save lives.

Some initial comments on the document:

  • We are pleased that the document recognises that more research needs to be done as a priority to help pin down more precisely what symptoms, or combination of symptoms, are good indicators of pancreatic cancer.
  • We support the inclusion of new onset diabetes in a weight-losing patient as a symptom that should trigger a referral for a CT scan. This joins a list of other symptoms combined with  weight loss that would trigger a scan.
  • However, we have concerns that the draft advice suggests this should only generally be considered for patients over 60. Likewise we have concerns that jaundice is recommended to be generally treated as a sign of cancer only in patients over the age of 40. As a charity with a patient support line we know of far too many cases of younger patients’ symptoms being missed because GPs think pancreatic is largely limited to older people.
  • We agree with the document’s statement that these referral guidelines will mean more scans are needed and that this will lead to pressure on local services in the short-run. We hope that this will lead to more resources being made available to allow necessary scans to take place.

The consultation closes on 9th January and we will be making a full, formal submission in due course. We will keep you posted as to any progress.