The guideline summarises current New Zealand and overseas evidence to inform the management of people presenting to primary care with signs and/or symptoms suggestive of cancer. It also summarises the evidence for disparity in the incidence, stage and mortality rate of cancer in New Zealand, and discusses possible reasons for the differences observed.
A related resource helps primary care practitioners make a timely and appropriate referral of patients by alerting practitioners to the features that should raise their suspicion of cancer.
Purpose
The aim of this guideline is to help primary care practitioners make a timely and appropriate referral by alerting practitioners to the features that should raise their suspicion of cancer.The guideline summarises current New Zealand and overseas evidence to inform the management of people presenting to primary care with signs and/or symptoms suggestive of cancer. Clinical Guideline 27: Referral Guidelines for Suspected Cancer, published by The National Institute for Health and Clinical Excellence (2005), provided key direction in the development of this guideline. The guideline also summarises the evidence for disparity in the incidence, stage and mortality rate of cancer in New Zealand, and discusses possible reasons for the differences observed.
Key Results
Key messages- Māori and Pacific peoples often present with cancer at a later disease stage. A higher degree of suspicion is therefore indicated when Māori or Pacific people present with symptoms suggestive of cancer
- As Māori and Pacific peoples often cite communication with health care providers as a barrier to care, practitioners should provide information to Māori and Pacific peoples, preferably face-to-face and supported with appropriate written information
- A high index of suspicion of a new primary or metastatic disease (especially bone, brain, liver or lung) is needed in a person with a history of cancer
- A person returning to a primary care practitioner with the same symptom three or more times should be considered an indication for referral
- The greater the number of signs and/or symptoms present the more important it is for a practitioner to act
- Listening carefully to what caregivers say about a child’s symptoms is essential as the interpretation of children’s symptoms in a clinical situation can be difficult
- Practitioners and others providing cancer care should receive training and support in culturally competent, patient-centred care so that barriers to access and referral can be lessened.