Increases in GP cancer referrals reflect successful health policy, not accidental overmedicalisation

Mathew is right to highlight the problem of overmedicalisation and the need for a coherent policy response to counterbalance the many pressures that lead to too much medicine.1 But the cited example of increased two week wait referrals for suspected cancer is not apt.As Mathew points out, volumes of two week wait referrals have increased substantially in recent years,2 but this is a result of a deliberate and appropriate policy emphasis on excluding cancer in symptomatic patients, even at relatively low levels of risk. In the same period that two week wait referrals doubled, cancer outcomes have improved markedly, with fewer patients diagnosed through emergency presentations3 and more patients diagnosed as having earlier stage disease.4 Evidence from large observational studies has vindicated general practitioners’ increasingly circumspect approach to possible presentations of cancer, with patients attending practices that use two week wait pathways more readily benefiting from improved outcomes.45Mathew notes that…
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