People with cancers of the mouth and oesophagus are waiting longer between first noticing a symptom and going to their GPs compared to patients with other types of cancers, according to research published in the International Journal of Cancer.
“These findings take an important step and suggest that lack of knowledge about symptoms may play a significant role in any delay in going to get checked out with the doctor for oropharyngeal and oesophageal cancer.” – Professor Jane Wardle
The findings highlight the need for awareness campaigns to focus on these cancers to increase symptom awareness and get people seeing their GPs sooner*.
Researchers from Cambridge, Durham and Bangor universities and the National Cancer Intelligence Network used data from the National Audit of Cancer Diagnosis in Primary Care about the GP consultations of more than 10,000 patients with 18 different cancer types**. They examined the number of days between a patient first noticing a symptom and them seeking medical help – known as the patient interval.
For patients with mouth – also known as oropharyngeal – cancers, the study found that the average time*** to visit their GP after noticing a symptom is around a month. And oesophageal cancer patients are waiting around three weeks to see their doctor about their symptoms. But, this was compared to patients with bladder and kidney cancers, who visit the doctor only two or three days after they first notice a symptom****.
Dr Georgios Lyratzopoulos, study author and NIHR post-doctoral fellow based at the University of Cambridge, said: “Oropharyngeal and oesophageal cancers are relatively common but both have a relatively poor outlook for survival.
“Previous research shows that two of the key symptoms for these cancers – difficulty swallowing and ulcers that don’t heal – are the least well-known by the public for their links with cancer.”
Professor Greg Rubin, study author from Durham University and clinical lead for cancer for the Royal College of GPs and Cancer Research UK, said: “Our research was based on information collected from patients by over a thousand GPs during a quality improvement audit, something never done before on such a scale. The result is better understanding of how people with different cancers react to symptoms and where efforts to raise public awareness should be targeted.”
Professor Jane Wardle, Cancer Research UK’s director of the Health Behaviour Research Centre based at University College London, said: “We know that some people are not aware of some of the less common early signs and symptoms of cancer. These findings take an important step and suggest that lack of knowledge about symptoms may play a significant role in any delay in going to get checked out with the doctor for oropharyngeal and oesophageal cancer.”
Sara Hiom, Cancer Research UK’s director of early diagnosis, said: “It’s good to see patients with kidney and bladder cancers going to their doctors so quickly, perhaps because their symptoms are more noticeable. But we must do more to encourage people with other less well recognised symptoms to see their GPs as soon as possible.
“Some symptoms are more obvious than others so the important thing is to get to know your own body and what’s normal for you. When cancer is diagnosed earlier, treatment is usually more effective and the chances of beating the disease are higher.”
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* Keeble, S et al. Variation in promptness of presentation among 10,297 patients subsequently diagnosed with one of 18 cancers: Evidence from a national audit of cancer diagnosis in primary care (2014) International Journal of Cancer. doi:10.1002/ijc.28763
**Successful national ‘Be Clear on Cancer’ campaigns are currently running for symptoms of bowel, lung, breast, bladder and kidney, oesophago-gastric and ovarian cancers; but do not currently include symptoms of oropharyngeal cancer: http://www.nhs.uk/be-clear-on-cancer/Pages/beclearoncancer.aspx .
***The research was carried out by Cambridge, Durham and Bangor universities and the National Cancer Intelligence Network of Public Health England. It was supported by the National Institute for Health Research.
****average = median
***** Table showing patient interval for 18 different cancers. (Full results are in the paper. The findings indicate that these differences cannot be explained by other factors such as patient age or gender):
Cancer type No of Patients Median patient interval (days)
Bladder 601 2
Renal 209 3
Brain 125 7
Breast 2124 7
Unknown Primary 110 7
Leukaemia 239 7
Prostate 1386 6
Pancreatic 272 9.5
Stomach 187 9
Lung 1126 12
Myeloma 127 14
Endometrial 311 14
Ovarian 270 14
Lymphoma 482 14
Melanoma 477 20
Colorectal 1697 19
Oesophageal 407 22
Oro-pharyngeal 147 30