As March is Prostate Cancer Awareness month, the Medical Protection Society (MPS) is reminding GPs to keep the disease front of mind, especially as there is no national screening for prostate cancer, which is predicted to become UK’s most common cancer by 2030. In an analysis of cancer claims against GPs, MPS noted that claims relating to prostate cancer were the sixth most common cancer claim.
From the analysis MPS identified a range of failings, which included; Not taking an adequate history and poor communication Delays in examinations and referrals Failure to perform examinations and specific diagnostic tests Misinterpretation/misreading or missing of results.
Dr Nick Clements, Head of Medical for the Medical Protection Society said, 'Prostate cancer is predicted to become UK's most common cancer in less than twenty years, and as there is no national prostate screening programme, GPs will have to increase their understanding of the disease and be watchful for the signs.
From the claims we looked at, one area of weakness was around communication, and not taking adequate histories. GPs should encourage patients to discuss their concerns openly and take a detailed history, as a family history is one of the strongest risk factors for prostate cancer. GPs should also carry out the appropriate checks and follow up referrals, as well as remind those in the "at risk group‟ about the importance of self-checks.
Talking about the difficulties some GPs encounter, Dr Clements noted, 'There may be reluctance and embarrassment for men to talk about symptoms which could possibly relate to prostate cancer, for example difficulty passing urine. Most men know that if they go to their doctor about symptoms which may be linked to prostate problems it could lead to a rectal examination which can be an uncomfortable and embarrassing experience. These factors combined might make it difficult for patients to raise concerns with their GP, which is where the GP's communication skills and ability to extract information become so important.
'GPs should continue to increase their understanding of the disease and bear in mind that delays or failures to examine and refer can lead to a poor prognosis for patients, and claims against the GP. If cancer is a reasonable possibility, it needs to be excluded from the differential diagnosis – if in doubt, rule it out.'
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Notes to Editor
1. Those claims analysed were from 2009-2010 and included MPS members practising as General Practitioners where cancer was the primary theme.
2. Most common cancer by 2013 - http://www.bbc.co.uk/news/uk-england-hampshire-21558255
3. Research funded by The Prostate Cancer Charity and undertaken by the University of Stirling's Cancer Care Research Centre revealed that men have a worrying tendency to delay before going to a GP to discuss symptoms which may be an indication of prostate cancer - http://prostatecanceruk.org/news/vital-time-wasted