Meeting the cancer challenge: GP involvement is key

As BJFM begins a major series on the GP’s role in diagnosis and management of cancer (see page 15), Mr Sean Duffy, National Clinical Director for Cancer for NHS England, highlights the role of GPs and underlines the importance of effective collaboration between primary and secondary care.

This is a welcome series for general practice and is timely in its publication. Cancer patients deserve the very best we can offer them in terms of experience of care and survival from their disease, once diagnosed. 

Since the start of the Cancer Plan in 2000 there have been year on year improvements in survival from cancer, and this is very welcome. However, there remains a gap between survival in the UK and the best in Europe and the rest of the world. Therefore more work is required. 

Many of the improvements have been as a result of better access to treatments and the re-organisation of services to place specialist multidisciplinary teams in the heart of the decision making once a diagnosis of cancer has been made. 

The remaining work is to ensure that two crucial things now happen: people with the symptoms of potential cancer have the diagnosis established at an earlier stage of the disease; and the emergency route to establish the diagnosis is reduced. 

Both of these require effective coordination between primary and secondary care and so greater closeness of these traditionally separate parts of the NHS. In addition, for GPs to act on suspicious or worrying symptoms, access to investigations needs to be optimum. 

If we diagnose patients at an earlier stage of the cancer then more curative treatments are possible. Can this be done? The answer is yes. The recent evidence from the Be Clear on Cancer campaigns has shown that, in lung cancer, the diagnosis can be made sooner, the referral for tests can be made quicker and more patients can have life-saving surgery. The benefits have been seen in hundreds of patients and so the real prize is an enormous gain for these patients and their families. 

There are ways to help reduce the variable stage at presentation of cancer, and this series will be a useful additional resource in this fight to improve the lot of our patients.