Why Cancer Symptoms May Elude M.D.
FRIDAY, Feb. 24 -- Diagnosing cancer is more difficult in certain groups of patients, according to a British study.
Researchers analyzed data gathered from more than 41,000 patients with 24 types of cancer who were treated in 158 hospitals across England. They found that 77 percent of those who saw their family doctor about suspicious symptoms were referred to a hospital after only one or two consultations.
However, the study found that women, young people, non-white patients and patients with less common cancers were more likely to see their family doctor three or more times before they were referred to a hospital.
The researchers identified large differences in the promptness of family doctors in England to diagnose different types of cancer. Patients with symptoms of multiple myeloma, lung and pancreatic cancer required many more consultations with their family doctor before they were referred to a hospital, compared to patients with more common cancers such as breast, melanoma and testicular.
For example, almost 51 percent of patients with the blood cancer multiple myeloma required multiple visits to their family doctor before referral, compared with less than 8 percent of breast cancer patients.
Differences in the nature and characteristics of symptoms may explain why certain cancers are more difficult to diagnose, the researchers said. For example, multiple myeloma is especially difficult to diagnose because it mimics other conditions, while a breast lump may readily suggest cancer, the authors said.
They also said that doctors may be less likely to consider cancer in younger patients and may have communication difficulties with patients from different ethnic groups, which may explain why cancer diagnoses can take longer in these patients.
The study appears online Feb. 24 in The Lancet Oncology.
"These findings highlight limitations in current scientific knowledge," lead author Georgios Lyratzopoulos, of Cambridge University, said in a journal news release. "Medical research in recent decades has prioritized improving cancer treatments, but knowledge about the 'symptom signature' of common cancers and practical solutions on how best to diagnose them is still emerging."
Martin Guilliford, of King's College London, wrote in an accompanying editorial that the findings raise several questions that should be tested in future research.
He said some of those questions are: "Do modes of cancer presentation vary systematically between different groups of patients? Are (family doctors) more reluctant to refer young or non-white patients for investigation of possible cancer? Are participants in these groups less willing to accept a referral to investigate possible cancer?"
The American Academy of Family Physicians has more about cancer diagnosis and tests.
Posted: February 2012
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