The role of risk tools in diagnosing cancer in primary care

Diagnosing cancer on the basis of a patient's symptoms and risk factors is a core role for general practice. Equally, as part of a cost-effective health system, GPs should avoid over-investigation or referral of patients who are very unlikely to have cancer. Diagnosing cancer in primary care is not straightforward because many of the symptoms of cancer have more common benign causes.

The aim of this article is to review the use of risk tools for diagnosing cancer in primary care.

Certain cancers, such as lung, pancreas, ovary and myeloma, are particularly challenging to diagnose early. National guidelines exist to support identification of patients who are more likely to have an undiagnosed cancer but these list single symptoms as so-called 'red flags'. Validated risk tools, developed in general practice, exist that predict cancer diagnosis on the basis of patterns of symptoms and risk factors. These tools might prove useful in supporting cancer diagnosis in general practice and also reducing investigation of patients at very low risk of cancer.