By Dr Bridget Gwynne, Macmillan GP Adviser in South Wales
Macmillan Cancer Support in Wales is working with 21 Welsh GP practices to test new technology to support GPs to diagnose five cancer types earlier.
Practices across Wales are testing an electronic tool to support them to diagnose bowel, lung, oesophageal /upper gastrointestinal, ovarian and pancreatic cancer.
These types of cancer were chosen for the pilot as their symptoms either present a particular challenge to GPs or are cancers for which an early diagnosis has a significant impact on the patient’s outcome.
We know that as many as 4,000 to 7,500 deaths per year across the UK could be avoided with earlier diagnosis.
There is also evidence that cancer is being detected and diagnosed later in Wales and that this plays an important part in the country’s poor survival rates. (Eurocare 4. Lancet Oncology 8:8 August 2007)
The cancer decision support tool runs alongside GPs’ clinical systems and is designed to be used during appointments to identify the risk that the patient may have an undiagnosed cancer.
The tool is based on two risk calculators for cancer: the Risk Assessment Tool (RAT), developed by Professor Willie Hamilton and QCancer developed by Professor Julia Hippisley-Cox.
It operates in two ways. It uses information from a patient’s records, including details about previous GP appointments, symptoms and family history, to calculate a patient’s risk of having cancer.
If the risk is higher than two per cent, the risk factor then appears as a reactive visual prompt on the GPs’ computers when they open up a patient’s record.
GPs can also use it to input a patient’s symptoms during the consultation to calculate their risk factor for these cancer types.
We hope the pilot will support GPs to manage the complex decision-making process for referring people who may have cancer, which will ultimately help them to diagnose these cancer types sooner.
We also hope it will help to build an understanding of how electronic tools can support GPs with the challenges of trying to diagnose cancer as early as possible to give patients the best outcome.
The pilot, which started in June, will finish in November and follows an earlier pilot in GP practices where the tool focused on bowel and lung cancer in 2012.
The GPs who are taking part in the pilot are being asked to give feedback every time they use the tool’s calculations.
They will be asked if the risk was lower, higher or about the same as they thought.
They will also be asked whether or not their decision-making had been influenced and, if so, in what way.
Cancer Research UK will be supporting the project by co-ordinating the evaluation of this pilot and we look forward to receiving the results next year.
Macmillan Cancer Support in Wales is delighted to be working with GPs on this issue.
With 18,000 people diagnosed with cancer every year in Wales – equivalent to 50 people a day – this is an important piece of work to analyse if these electronic tools can support GPs to make an earlier diagnosis for these cancer types.
- To find out more about the pilot and other work Macmillan is doing with GPs in Wales, email me via firstname.lastname@example.org.