ABSTRACT
Recognising cancer can be difficult. It is especially tricky in primary care where cancers are rare, there is a greater reliance on symptoms, and general practitioners are constantly bombarded with guidelines and initiatives that ignore the primary care context. A failure to appreciate that we may be using such heuristics can result in important cognitive errors being made by clinicians working in a primary care context who have spent a significant period employed or studying in secondary or tertiary care settings. Much cancer referral guidance designed for general practitioners lists, in traditional 'textbook' fashion, the symptoms and signs of the most common cancers. Unfortunately, very little consideration is often given to the applicability, the validity and the reliability of such information. Traditionally it has been suggested that the risk of colorectal cancer is greater in those with new onset rectal bleeding.
