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Men and poorer people most likely to miss appointments for suspected cancer

System flaws, anxiety and difficulty getting time off work are key reasons

Men, the elderly and people from deprived areas are among the patients most likely to miss an urgent referral appointment for suspected cancer, a study led by the University of York has found.

The study, funded by Yorkshire Cancer Research, interviewed GPs and patients who had missed their appointment in order to understand the factors that contributed to their non-attendance.

The researchers found that some patients were let down by flaws in the appointment system and in some cases referral letters arrived too late because of the fast-paced nature of the referral process.

Other reasons included patients’ fear of the diagnosis or procedures they may have to undergo.

Patients from deprived areas also reported struggling to negotiate time away from work and finding the money for transport costs, as well as complications arising from other health problems and wider life struggles.

Earlier in the year, research by the same authors found that around 5% to 7% of patients miss or cancel urgent referrals. Of the patients who skipped their appointment, those who later discovered they had cancer were 12% more likely to die within a year of diagnosis.

The NHS’s two week wait policy aims to ensure that a consultant sees patients with suspected cancer within two weeks of an urgent GP referral.

More than 1.9 million two week wait referrals are made annually. While almost half of all cancers are identified through this route, for 92% of patients referral will exclude cancer.

Dr Stuart Griffiths, director of research and services at Yorkshire Cancer Research, said early diagnosis is vital in ensuring more people survive cancer, but there are many challenges facing both doctors and patients when it comes to accessing diagnosis and treatment swiftly.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, claimed that GPs are highly skilled communicators who will always try to strike the difficult balance of conveying to patients the importance of attending two week wait referral appointments, without causing them undue worry and anxiety.

“We are highly trained to have difficult conversations, but we need more time with our patients and the traditional 10-minute appointment is increasingly unfit for purpose. This research provides further evidence to support the college’s calls for 15-minute appointments as standard for our patients with complex needs,” she said.