Women, young people and those from ethnic minorities are the most difficult to diagnose with cancer, according to British experts.
Dr Georgios Lyratzopoulos, from Cambridge University, England, who led the study, said people the young and those from BME groups were more likely to have several GP consultations before hospital referral compared with older or white patients.
He said this suggests that GPs are less likely to consider cancer a possibility in young people. There may also be communication difficulties with patients from different ethnic groups, he said, in The Lancet Oncology, which reports the survey.
Women were more than twice as likely as men to have three or more consultations with their doctor before a decision to refer to hospital is made to diagnose bladder cancer. This is because there can be difficulties in discriminating cancer symptoms from those of benign gynaecological conditions or bladder infection.
Using data provided by more than 41,000 patients with 24 different cancers, the authors examined variation in the number of times patients presented with symptoms of cancer to their family doctor before being referred to hospital according to cancer type, age, sex, ethnic group, and socioeconomic status.
Seventy-seven per cent of patients who first present to their GPs with suspected cancer symptoms were referred to hospital after one or two consultations, but women, young people, non-white patients can see their GPs at least three times before they were referred.
Patients with some less common cancers, such as multiple myeloma, Hodgkin’s lymphoma, and cancers of the pancreas, stomach, lung, colon, and ovaries, were also substantially more likely to see their GP three or more times before being referred to hospital.
It is thought delayed recognition of these cancers could be because of differences in the nature and characteristics of symptoms, making them harder to diagnose. Cancers with well known signs and symptoms, such as changes to moles or an obvious lump are more easily diagnosed.
“These findings highlight limitations in current scientific knowledge,” said Dr Lyratzopoulos. “Medical research in recent decades has prioritised improving cancer treatments, but knowledge about the ‘symptom signature’ of common cancers and practical solutions on how best to diagnose them is still emerging.”
The report calls for better use of technologies to help GPs calculate a patient’s risk of cancer and to improve their ability to spot symptoms earlier.
Writing in the journal, Martin Gulliford from King’s College London, UK, said the findings raised many questions about cancer diagnosis.
Variation in number of general practitioner consultations before hospital referral for cancer: findings from the 2010 National Cancer Patient Experience Survey in England Georgios Lyratzopoulos, Richard D Neal, Josephine M Barbiere, Gregory P Rubin, Gary A Abel. The Lancet Oncology. February 24 2012. doi: 10.1016/S1470-2045(12)70041-4
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