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No Evidence on Safety-Netting for Cancer Detection in Patients with Vague Symptoms

SCIENTISTS have highlighted the absence of evidence on whether safety-netting can improve cancer detection in patients with vague symptoms.

Safety-netting in cancer diagnosis is a strategy used by healthcare professionals which involves timely and appropriate follow-up with patients who present non-specific symptoms. However, in a new study, Dr Brian Nicholson and his colleagues at the University of Oxford, Oxford, UK, found no evidence on whether safety-netting is an effective intervention for patients with low-risk, but not no-risk, symptoms of cancer. The team also identified no ongoing research to address whether safety-netting is effective for these patients, nor how it should be done.

However, the team did find some evidence guiding how best to carry out the intervention in patients with vague symptoms by drawing from expert opinion and previous investigations into diagnostic delays. For example, the study considered the guidance offered by Dr Roger Neighbour’s definition of safety-netting which is comprised of three questions that clinicians should ask themselves when making a diagnosis:

  • If I’m right, what do I expect to happen?
  • How will I know if I’m wrong?
  • What would I do then?

The team said that they found little evidence which can be used to guide the clinician for effective safety-netting. This includes no research on how the clinician and patient should share responsibility for monitoring ongoing symptoms and how re-consultation can be facilitated.

“Although the evidence base is uncertain, safety-netting remains the best option, and is likely better than nothing,” the researchers said in a statement. “It is important that patients continue to visit their doctor until their symptoms are explained. We know that doctors are safety-netting every day to keep their patients safe. By conducting research on safety-netting we will be able to understand which safety-netting messages and systems are effective.”

Jack Redden, Reporter

Keywords: Cancer, detection, Diagnosis, Safety-netting, vague symptoms