Doctors’ ‘gut instincts’ better at catching cancer than just a symptoms checklist

Doctors with the experience to “go with their gut instinct” are better at diagnosing cancer than those who simply go through a list of symptoms, research suggests. 

The systematic review by Oxford University examined the way GPs took decisions to refer patients for investigation of symptoms which could indicate cancer.

The research revealed that when family doctors were recorded acting on intuition or instinct, patients were far more likely to end up being diagnosed with the disease. 

The research suggests that GP experience was key – with one study showing that every extra year in age increased the likelihood that gut suspicions were correct.

Overall, the odds of a cancer diagnosis were four times higher when “gut feelings” were recorded by medics making the referrals, instead of only following checklists of symptoms, the analysis found. 

Current guidelines from the National Institute of Health and Care Excellence (Nice) advise GPs to act on any suspicion of cancer, not just on symptoms that are seen as “red flags”.

Researchers said that GPs were more likely to pick up on “non-verbal cues” such as the way a patient sat or spoke, or a change in their appearance, if they had got to know their patients. 

One doctor in the studies said: “If you know them well and if you see a dramatic change as they’re walking through the door, either weight loss or there’s a colour about them… it’s just a gut instinct.” 

Such signals gave doctors a “sense of alarm” about an underlying problem, rather than pointed to a specific diagnosis, researchers said. 

The study, published in the British Journal of General Practice, prompted warnings that such signs could be more difficult to detect during phone and video consultations. 

Dr Jonathan Leach, honorary secretary of the Royal College of GPs, said: “GPs consider a huge variety of factors when making a patient diagnosis.

“As well as more obvious physical symptoms, non-verbal cues can often indicate that something is wrong – not necessarily what the patient has made an appointment to speak about.” 

“This ‘gut feeling’ or intuition is something that GPs develop by having close, trusting relationships with patients that are often built over time, and isn’t something that should be ignored.”

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