Cancer Patients Who Skip an Urgent Referral Appointment Are More Likely to Die

A study published in Cancer Epidemiology shows that cancer patients who skip an urgent referral appointment for their symptoms are more likely to die within 12 months of diagnosis.

This study, led by researchers at the University of York and Hull York Medical School, examined data from more than 100,000 patients who had been urgently referred by around 100 different GP practices in the North of England. While most patients in the study (95%) attended their referral appointment, but a significant minority (5% or 5,673 people) did not.

While the study found that only one in 18 of the patients who skipped their appointment went on to be diagnosed with cancer – juxtaposed to one in 10 of those who did attend – the outlook for patients who missed their appointment and did have cancer was notably worse compared to those who attended their appointment.

According to the results of the study, 34.6% of non-attending patients with cancer had an advanced stage of the disease at diagnosis compared to 18.4% of attenders with cancer. Moreover, according to the researchers having a more advanced stage of the disease is likely to be a reason why more non-attending patients with cancer died within a year of diagnosis (31.3% compared to 19.2% of attenders), the researchers say.

“Our study showed cancer diagnosis was less likely in non-attending patients but those who are diagnosed have worse outcomes than attending patients with cancer,” said Dr Peter Knapp, from the Department of Health Sciences at the University of York and Hull York Medical School.

“Non-attendance at urgent referral appointments for suspected cancer involves a minority of patients, but happens in somewhat predictable groups. For example, we found that patients with suspected gastrointestinal cancer were among the least likely to attend – this may be due to concerns about unpleasant or embarrassing procedures.

“Our research suggests that more could be done to identify individuals at risk of non-attendance and offer extra support.”

The NHS’s ‘Two Week Wait’ policy aims to ensure that patients with suspected cancer are seen by a consultant within two weeks of an urgent GP referral.

While there is more awareness around the issues of ignored cancer screening invitations and the waste of resources incurred from missed GP appointments, the study is the first to focus on non-attendance of symptomatic patients referred due to suspected cancer.