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On 2 November 2023, Cancer Australia unveiled the Australian Cancer Plan, emphasising a strategic commitment to “maximising cancer prevention and early detection”. This initiative holds particular significance for general practice, as most cancer diagnoses originate from symptomatic presentations to primary care, even when screening programs are available. For context, full‐time general practitioners on average diagnose up to 12 non‐cutaneous cancers annually, but they see patients consulting with symptoms associated with cancer almost daily.

By its very nature, general practice is characterised by breadth and whole‐person patient‐centred care. Patients present with undifferentiated symptoms unconfined to a specific population group, organ or system in a setting where the individual likelihood of cancer is low. As a result, the pre‐test probability of a particular symptom being attributable to cancer is substantially lower than in secondary care settings, which are by default a selected subset of patients.5 The apparent strong associations between a single cancer type and specific symptoms seen in secondary care are diluted when applied to the low prevalence context of general practice. For example, although around half of patients diagnosed with pancreatic cancer initially exhibit abdominal pain, the risk of isolated abdominal pain being attributable to pancreatic cancer in the primary care population is well below 1%.

This MJA Perspective shares more.

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Authors: Brent Venning and Jon D Emery

Article Type: Perspective