GPs warn time pressure and NHS strain are making genealogical cancers harder to diagnose early in Wales

A new poll has revealed the significant challenges GPs across Wales face in diagnosing gynaecological cancers, with almost half (49%) saying limited consultation time is a major concern.

The Censuswide Poll, commissioned by us in support of Claire’s Campaign, highlights views from GPs into how they respond to women who present with gynaecological symptoms that may be cancer.

The findings, based on responses from 100 frontline GPs across Wales, were commissioned to raise awareness about the reality of women’s experiences with gynaecological cancer in Wales.

Welsh Government data shows that targets for timely cancer treatment are not being met, while women report feeling dismissed, delayed and unheard when presenting with symptoms.

Our own insight shows the incidence rate for gynaecological cancer in Wales is higher than the UK average, as is the mortality rate.

Every year, there are nearly 1,200 cases of gynaecological cancers in Wales and around 470 women die of the disease.

In July 2022, only 38% of gynaecological cancers met the Single Cancer Pathway target (for no patients to wait longer than 62 days for treatment). Almost four years later, that figure stands at 50.7 per cent. Waiting times for gynaecological cancer treatment remain poorer than for many common cancers. While improvements have happened, progress has been slow and for many women, too late.

The poll highlights challenges in diagnosing gynaecological cancers, with systemic issues playing a critical role.

Among the key findings, GPs reported that early diagnosis was made more difficult because of:

• GPs fearing over-referring patients into an overburdened NHS  = 34%
• Limited primary care consultation time =  49%
• Difficulty distinguishing cancer symptoms from common benign conditions (such as IBS) = 39%
• Limited access to timely diagnostic tests and specialist referrals
• A need for clearer clinical guidance and enhanced training

Early diagnosis is critical in improving survival rates for gynaecological cancers, but systemic barriers within primary care and referral pathways are making this increasingly challenging. 

Gareth Howells, CEO at Tenovus Cancer Care, said:

Dr Kathrin Thomas, who is a consultant in public health and a retired GP working with Deep End Cymru, who has focused on tackling health inequality much of her working life, said the results were revealing.

She added: “The biggest issue identified by GPs was limited consultation time. They need time to listen to women’s concerns, especially when these are not straightforward or typical, and time to examine them appropriately.

“We now have fewer GPs in Wales than anywhere else in the UK and numbers have not increased in the last few years, even though demand in General Practice has significantly increased.

“GPs are aware that over-referral into the NHS would result in even more women having unnecessary invasive tests, so GPs need time to be able to find the balance to ensure that those with symptoms are referred, whether they are in a high-risk category or not. 

Dr Thomas continued: “If we want women to be heard the biggest thing we can give them is time. GPs really want to do the best they can, but what is limiting them is the lack of time so they can pick up those unusual presentations; the more complex; the more unusual and difficult cases which requires continuity of care as well.

“The critical point now is continuity of care. If people see the same GP most of the time, it is really good for their long-term health. We know there is a 20 per cent reduction in mortality over ten years for people  who have high continuity of care, and they are also less likely to be admitted to hospital and need fewer appointments.” 

Enlli Thompson, who was diagnosed with Ovarian cancer at the age of 19, feels the route to her own diagnosis was met with many obstacles.

She explains: “A woman's health concern should never be deprioritised due to concerns about overburdening the healthcare system. If the system is overburdened, this highlights the need for additional support and improvement.

“Regarding the lack of consultation time, I completely agree. When a woman like me and many others, whom I have come to know during our journeys, go back and forth to the GP over many months, and they do not look at the patient's notes and think there's something not right here.

She added: “These months passed with shocking diagnoses that had me leaving the surgery with more questions than answers, to the point I started believing I was just dramatic. But if I had that longer appointment, if they had the time to properly read my notes. Could things have been different?”