GPs 'slow to refer 1/4 of cancer patients' Many cancers - notably those of internal organs - also have symptoms that are very difficult to spot early, or are easily confused with much more common but less serious conditions. The researchers examined data from more than 41,000 adults with 24 different types of cancer, from the 2010 National Cancer Patient Experience Survey. It in, they were asked to recall how many times they saw a doctor with health problems that turned out to be signs of cancer. Writing in The Lancet Oncology, the academics noted: "We identified wide variation between cancer types in the proportion of patients who had visited their general practitioner three or more times before hospital referral." Just one in 13 breast cancer patients (7.4 per cent) and one in 10 (10.1 per cent) skin cancer patients had to visit their GP at least three times before referral. However, half of patients (50.6 per cent) later diagnosed with multiple myeloma - white blood cell cancer - had to endure at least three GP appointments, while four in 10 pancreatic cancer patients (41.3 per cent) had to wait that long. Lung, stomach, colon and ovarian cancer patients were also "substantially" more likely to have needed three of more GP visits. The authors said GPs should be "mindful" of "the need for a heightened index of suspicion" when presented with symptoms that could indicate such cancers. Georgios Lyratzopoulos, the Cambridge public health expert who led the study, said: "Medical research in recent decades has prioritised improving cancer treatments, but knowledge about the "symptom signature" of common cancers and practical solutions on how best to diagnose them is still emerging." Young people aged 16 to 24 were more than twice as likely to have delayed referral as older patients, while Asian and black patients were about 75 per cent more likely than whites to have to go through at least three GP appointments. This prompted the academics to warn: "Clinicians should also be aware of the potential for communication barriers with young people and patients from ethnic minorities to delay referral." Martin Gulliford, professor of public health at King's College London, asked: "Are GPs more reluctant to refer young or non-white patients for investigation of possible cancer? Are participants in these groups less willing to accept a referral to investigate possible cancer? The study follows a report by The King's Fund, a health think tank, last spring that found "growing evidence" GPs were making later referrals for cancer patients, "possibly resulting in late diagnosis and poorer survival chances." Last September it also emerged that some local health authorities were looking at ways to reduce the number of patients GPs referred on for cancer tests. Greg Rubin, professor of general practice and primary care at Durham University, who worked on the study, said: "A GP sees on average eight new patients with cancer each year, and might just see a handful of rarer cancers in his whole career. It's a challenge to recognise some of them, particularly if they present with common symptoms. A Department of Health spokesman said the Government had committed £450 million to help diagnose cancer earlier, to try to save 5,000 more lives a year. She said: "This money will give GPs' direct access to tests to allow quicker diagnosis. This extra investment will also fund awareness campaigns of signs and symptoms for GPs and the public, as well as the extra costs for secondary care as more people are referred for specialist treatment.