When the general practitioner quickly sends the patient to be examined for cancer, mortality falls significantly. These are the findings of a new study of British cancer patients that has been led by researchers from Aarhus University. The British are looking at the Danish strategy for early diagnosis with cancer care pathways and diagnostic centres.

2015.11.02 | Helle Horskjær Hansen

In the UK, general practitioners can utilise a ‘two week wait system'. The two week wait system corresponds to the Danish cancer care pathway and involves sending the patient through a well-structured and efficient examination process or pathway, so they are diagnosed quickly and can begin treatment.

A recently published study in the British Medical Journal (BMJ) shows that general practitioners who most often make use of this option save lives. The study concludes that the difference in cancer survival is as much as twelve percentage points depending on how quickly and effectively the patient receives a diagnosis and begins treatment.

Henrik Møller from Kings College in London and Aarhus University is behind the study, which has followed cancer patients for four years from the time of their diagnosis. The results showed that when cancer patients were more often admitted into the two week wait system, and thus were given the opportunity for a fast and well-structured examination and diagnosis in the hospital system, the mortality rate was lower than if more cancer patients ended up in a less coordinated process.

Transferable to Danish conditions

Professor Peter Vedsted from the Research Unit for General Medical Practice at Aarhus University calls the British study a “landmark” and says that the results are transferable to Denmark. 

"This is the first ever study to show that the more patients the general practitioner admits to the Danish cancer care pathways and the more often the general practitioner makes use of the cancer care pathways, the lower the mortality rate among all cancer patients. This demonstrates that our strategy to support earlier diagnosis and better organised diagnostic pathways can have an effect on the prognosis," says Peter Vedsted.

Inspiration from Denmark

The two week wait system has been used in the UK since the beginning of the millennium. The relevant decision-makers in the UK are currently discussing how – and what will be required – to examine even more patients quickly and efficiently for cancer – and they are finding inspiration in Denmark. 

"They’re doing this because in Denmark we have made more progress towards ensuring that patients can receive 'earlier diagnosis' – namely with the help of cancer care pathways, diagnostic centres and perhaps also soon ‘yes-no’ examinations. These initiatives form what we call the 'three-pronged strategy for diagnoses'. Two of the three prongs are in place. If you go to your GP with an alarming symptom such as blood in your excreta, then you will be immediately referred to a cancer care pathway," explains Peter Vedsted.

Should be offered a yes-no examination

People who visit their GP with serious, non-specific symptoms such as fatigue, can be referred to a medical examination at a diagnostic centre. 

- The final prong is the patient who visits the doctor with 'normal' symptoms that are most often not cancer, but which can be cancer in rare cases. This could be a patient who has lately had several bouts of pneumonia. These patients should be offered easy and fast access to simple clarifying examinations. We call this a 'yes-no’ examination, which can quickly help the doctor to clarify whether he or she should still suspect that the patient could have cancer, or whether a wait and see approach is better,” says Peter Vedsted.

Read the original article in the BMJ

Further information

Peter Vedsted
Department of Public Health and Department of Clinical Medicine, Aarhus University
Tel.: (+45) 2083 8259
p.vedsted@alm.au.dk