Urgent cancer referral guidelines: a retrospective cohort study of referrals for upper gastrointestinal adenocarcinoma.
Dyspepsia in primary care is common and guidelines indicate that patients with alarm symptoms, as defined by the urgent cancer referral guidelines, should be investigated by gastroscopy. The specificity and sensitivity of alarm symptoms is poor and only a small percentage of patients will turn out to have malignant disease. This primary care study shows that employing current guidelines will identify only 72% of patients at their initial visit to a general practitioner, but this figure could be increased to 86% if the guidelines included patients with weight loss or anaemia in the absence of dyspepsia. Past performance indicates that the majority of patients with the commonest symptom complex were not referred quickly and less than half were seen within 4 weeks.
South Tyneside District Hospital, South Shields. simon.panter@sthct.nhs.uk
Simon J
SJ
Panter
Mike G
MG
Bramble
Hilda
H
O'Flanagan
A Pali S
AP
Hungin
D000230:Adenocarcinoma / Q000175:diagnosis*; D000368:Aged; D015331:Cohort Studies; D004415:Dyspepsia / Q000209:etiology; D005194:Family Practice / Q000592:standards; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis*; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000592:standards*; D012189:Retrospective Studies; D013997:Time Factors; D006113:United Kingdom