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I have read (and re-read) the letter by Ramsey I Cutress and Toral Gathani on the cancer referral threshold.
I wonder whether there needs to be clarification on what the 3% threshold represents. 3% risk of a cancer diagnosis as a threshold for referral is different to achieving 3% conversion rate to cancer diagnosis following urgent referral.
A patient with a <3% risk of a cancer diagnosis does not meet the threshold for referral, however, many patients referred will have a >3% risk of cancer diagnosis, sometimes significantly so. It is, therefore, impossible to achieve a 3% overall conversion to cancer diagnosis unless some patients are referred with a <3% risk of cancer diagnosis.
It is therefore incorrect to state that the proportion of cancer diagnoses following urgent referral remains above twice that recommended.
It would be useful for commentators and GPs to have a new and accurate goal for conversion rate, as conflating the two figures may encourage referral below the 3% threshold or imply that there needs to be a review of referral criteria.
3% cancer referral threshold
Dear Editor,
I have read (and re-read) the letter by Ramsey I Cutress and Toral Gathani on the cancer referral threshold.
I wonder whether there needs to be clarification on what the 3% threshold represents. 3% risk of a cancer diagnosis as a threshold for referral is different to achieving 3% conversion rate to cancer diagnosis following urgent referral.
A patient with a <3% risk of a cancer diagnosis does not meet the threshold for referral, however, many patients referred will have a >3% risk of cancer diagnosis, sometimes significantly so. It is, therefore, impossible to achieve a 3% overall conversion to cancer diagnosis unless some patients are referred with a <3% risk of cancer diagnosis.
It is therefore incorrect to state that the proportion of cancer diagnoses following urgent referral remains above twice that recommended.
It would be useful for commentators and GPs to have a new and accurate goal for conversion rate, as conflating the two figures may encourage referral below the 3% threshold or imply that there needs to be a review of referral criteria.
Competing interests: No competing interests