A quarter of patients with cancer see their gp once or twice before being referred Cancer is a time structured upon disease.Lost time denotes lost lives.Diagnosis should not be delayed in any case and all the best provisions should be in place to promote the best patient outcome.Public learning, screening programs and rapid referral pathways are all crucial in this schema. We read your content by susan mayor, with advantage and concern.We were so startled by the declare that we undertook a small audit in our own practice in newport, pembrokeshire to explore whether the presented national trends exist in rural west wales. Inside course of 2010, 21 of our 5960 victims(0.4%)Were clinically determined to have cancer.Of these women, 19(90%)Were women, and associated with those 9(43%)Were detected by national breast and cervical security scanning services. One's audit, 11 victims(52%)Were referred by the consulting gp on the first public speaking event and 2(10%)Were alluded on the second visit.No patients desired 3 or more visits before referral.The residual 9 patients(43%)Were referred directly on first discussion by screening services.Whilst definitive cancer diagnosis is made by histological study, the time a cancer diagnosis was considered highly likely was observed.The gp noted this in 9 victims(43%)On the prospect letter, another 9 daily life(43%)Were located at screening services, and 3 particular person(14%)Had the top differential proper diagnosing cancer made in secondary care. We noted that 6 individuals(29%)Offered 'red flag' symptoms(Honest haematuria, jugg lump, testicular mass, most cancers in situ)And were opular via the 2 week urgent referral pathway.Of, 3(50%)Were seen within a few 2 weeks.Of tenacious 15 patients(71%), Only another 3(20%)Were seen within of 14 days.At the aim of diagnosis, 15 users(71%)Had locally wide spread disease, one(5%)Had nodal direction and 5(23%)Had metastatic conditions. We looked at the 'hold up' times within the referral process to try and identify how this process could be made better and expeditious.From the date of gp referral to the date of being seen by a secondary care company, the regular 'hold up' time was 33 days(Stretch 6 79 days).The average 'hold up' time in accessing deliberate or not or treatment if indicated by the specialist was 24 days(Wide number 6 55 days).Typically, from referral to search or treatment, a 'hold up' time of 57 days been with us. There were no referral dates or secondary care consultation dates out there the 9 patients(43%)Detected by national diagnostic tests services.We referred to 3 patients(14%)Who had additional 'hold ups' in seeing the secondary care specialist due to non attendance or ill health leading to deferral of amenities. Whilst our sample was restricted to size, we found that our results largely backed mayor's findings.Interestingly we observed that 90% of patients identified as having cancer were female and of those 47% were detected and referred from the national breast and screening services.Does this reflect the insufficiencies in equivalent male screening programs or that men, for the most part, are less aware of medical concerns than women?Then again, is national screening 'over diagnosis' a considerable problem? We found that 52% of our patients were referred on their first event, and that all patients were referred within at most two visits.These results may actually contrast mayor's findings.We do however agree that patients presenting with known 'red flag' symptoms are referred earlier.This probably relates to a clearer message regarding management of these bits of information and easier pathways for referral to secondary care such as one stop clinics. Even though there were fewer visits needed for referral to secondary care, there were significant delays between referral and specialist discussion(33 days;Amount 6 79 days)And between specialist deliberation and investigation/ treatment(24 days;Series 6 55 days).In our structure, the average hold up time from initial primary care talk through cheap jordans shoes to investigation/ treatment was 57 days. Where does supply really lie?Understand the issues causing delay in cancer diagnosis?Are referral rates beyond their budget?Is this due to raised patient awareness, more desirable screening or unrealistic targets?Perhaps gps' fears of litigation interfere with clinical making decisions?Are the nhs cancer referral pathways simply loaded down, and the facilities and resources too little to meet real demands? We agree it is unacceptable that a quarter of patients see their gp many times before referral and that significant delays do exist in diagnosing cancer.We all share job to improve cancer referral practice. White wc. (2000).Overdiagnosis:An underrecognized cause of confusion and harm in cancer testing.J natl cancer tumors inst;92(16):1280 2. Mansell gary the gadget guy, hot m, the nike jordans jl, michael the air nike jordans kp. (2011).Surgery to reduce primary care delay in cancer referral:An organized review.Br j generation pract;61:735 736. Zackrisson s, andersson i do, janzon d, mancer l, garne jp. (2006).Rate of over diagnosis of cancer of the breast deals on jordans shoes 15 years after end of malm mammographic screening trial:Follow-Up study.Bmj;332:689 692. 4 visits to a GP before being referred to an established could easily mean a 6 month delay in proper care. In my unique, delaying good Air Jordan 14 care for 6 months in a woman with breast, cervical or ovarian types of cancer, risks difficult her condition, by ever-Elevating cancer staging.