Cancer care has not caused waiting lists to mushroom

The NHS is under extreme pressure. We agree with Mathew that poor access to general practice, mental health services, and elective hospital care needs tackling,1 but efforts to diagnose and treat cancer are not to blame.Mathew argues that the 3% risk threshold for urgent cancer referral has led to inequity with other conditions and that improvements in cancer diagnosis (which have now been evidenced2) do not explain recent increases in survival. Mathew acknowledges improvements in stage at diagnosis and reduced emergency presentations but questions the survival benefits; lead time bias, however, is a minor part of symptomatic diagnosis (though important in screening). The 3% threshold recognises that diagnostics services are a limited resource—if the threshold was higher, we would fail many patients visiting their general practitioner. Can we really envisage GPs being discouraged from investigating haemoptysis in a smoker, for example (risk of lung cancer 4.5%)?3Mathew asks if the guideline…
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