England gives GPs software to predict cancer

All GPs in England will get software that calculates patients' risk of developing cancer, to reduce 10,000 annual deaths caused by late diagnosis

The Guardian
Smart Healthcare, Monday 4 January 2010 11.32 GMT

The new approach by the NHS means that doctors will tell patients their percentage chance of having cancer, based on factors like their age, weight and symptoms such as bleeding or sudden weight loss, reports The Guardian.

Professor Mike Richards, the government's cancer tsar, said that within five years every GP in England should be using the software as part of a new drive to reduce the huge toll of avoidable cancer deaths.

Computer-assisted cancer risk assessment will help GPs estimate whether a patient's symptoms could indicate the presence of a cancer and decide whether they needed to refer them for urgent tests in hospital, Richards said.

The computer would assess a patient's age, weight and symptoms – such as rectal bleeding and constant fatigue – and if the risk were above a certain level, the person would be referred to hospital for urgent exploratory tests within two weeks.

Cancer is the UK's biggest killer after heart disease and strokes. Every year 293,000 people are diagnosed with cancer, and about 155,000 die of it. GPs are vital because they spot the signs of cancer in 90% of patients, with screening picking up the other 10%. But a typical GP sees only eight or nine cases of cancer a year.

Britain is far worse than many European countries at diagnosing cancer early, when it is more likely to be treatable and the patient has a much better chance of surviving. That is partly because some patients who develop symptoms delay seeking help, but also because GPs sometimes fail to correctly identify signs of cancer.

Support technology is needed because of that poor record, the difficulty of diagnosing cancer and the sheer number of other ailments that GPs have to know about, Richards said.

There are more than 200 forms of cancer, and many of their symptoms are the same as for a range of other, often less serious, conditions. Computers could help doctors get it right more often when deciding whether to investigate a patient further, discharge them or refer them to hospital.

"This is helping GPs because none of us can retain this sort of information (about cancer symptoms) and having to retain it for bowel cancer, lung cancer and ovarian cancer, as well as for heart disease, it would take a remarkable human brain to be able to do that, so why not get computers to support it?" said Richards.

"The benefit of this will be that GPs will know who should be investigated and who shouldn't. It will also help patients to know that whether they are being reassured, or referred, or getting a test, that is the right thing to do."

Richards said the system would mean "better decision-making by GPs, leading also to earlier diagnosis of cancer patients".

England is understood to be the first country in the world to move to introduce such technology, according to the Department of Health. A number of GP practices across the country will take part in a pilot programme to assess the effectiveness of assisted cancer risk assessment, starting in the spring. GPs have recently begun using similar software to help them assess a patient's risk of developing cardiovascular disease. It analyses blood pressure, family history, cholesterol, smoking history and current symptoms before producing an odds ratio.

The plan to extend the approach to cancer is underpinned by a series of recent DH-funded research studies by Dr Willie Hamilton, an Exeter GP and expert in cancer diagnosis at Bristol University.