Rammya Mathew: Are we a cancer service or a health service?

For years, cancer survival rates in the UK have lagged behind those of other countries with comparable wealth and income.12 In response, in 2015 NICE published new guidance on the referral of suspected cancer in primary care, explicitly specifying that any symptom constellation that conferred a 3% or greater risk of representing a cancer diagnosis should automatically be referred through an urgent “two week wait” referral pathway.3Researching the rationale for the 3% threshold led me to discover that this wasn’t based on robust economic analysis—just that the guideline development group believed that such a change “would not overwhelm clinical services, nor would it greatly increase the possible harms to patients from over-investigation.”3 But did they foresee that referrals for suspected cancer would rise exponentially,4 or that in coming years we’d have more than seven million people waiting for elective care on an NHS waiting list?5It’s true that some cancer outcomes…
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