If it takes more than three trips to the GP to be referred for cancer tests, patients are more likely to be dissatisfied with their overall care, eroding confidence in the doctors and nurses who go on to treat and monitor them, according to new research.

This research shows that first impressions go a long way in determining how cancer patients view their experience of cancer treatment

Georgios Lyratzopoulos

The results are based on further analysis of survey data from more than 70,000 cancer patients, by Cancer Research UK scientists at the University of Cambridge and University College London, published today in the European Journal of Cancer Care.

Of the nearly 60,000 survey respondents diagnosed through their GP, almost a quarter (23 per cent) had been seen three or more times before being referred for cancer tests.

Four in ten (39 per cent) of those who had experienced referral delays were dissatisfied with the support they received from their GP compared to just under three in ten (28 per cent) of those referred after one or two GP visits.

Overall, patients who had seen their GP three or more times before being referred were more likely to report negative experiences across 10 of 12 different aspects of their care. For example, 18 per cent of these patients were dissatisfied with the way they were told they had cancer, compared to 14 per cent among those who were referred more quickly.

Four in ten expressed dissatisfaction with how hospital staff and their GP had worked with each other to provide the best possible care, compared to one in three among those referred promptly.

Dissatisfaction with the overall care received was even higher among the just under one in ten (9 per cent) patients who saw their GP five or more times before being referred.

Study author Dr Georgios Lyratzopoulos, from the Department of Public Health and Primary Care at the University of Cambridge, said: “This research shows that first impressions go a long way in determining how cancer patients view their experience of cancer treatment. A negative experience of diagnosis can trigger loss of confidence in their care throughout the cancer journey.

“When they occur, diagnostic delays are largely due to cancer symptoms being extremely hard to distinguish from other diseases, combined with a lack of accurate and easy-to-use tests. New diagnostic tools to help doctors decide which patients need referring are vital to improve the care experience for even more cancer patients.”

Dr Richard Roope, Cancer Research UK’s GP expert, said: “It’s vital we now step up efforts to ensure potential cancer symptoms can be investigated promptly, such as through the new NICE referral guidelines launched last month to give GPs more freedom to quickly refer patients with worrying symptoms. This will hopefully contribute to improving the patient experience, one of the six strategic priorities recommended by the UK’s Cancer Task Force last week.”


Mendonca S.C. et al, Pre-referral general practitioner consultations and subsequent experience of cancer care: evidence from the English Cancer Patient Experience Survey, European Journal of Cancer (2015)

Adapted from a press release by Cancer Research UK.

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