A third of patients who have symptoms of cancer visit their GP twice or more before being referred to a specialist, according to a new report.
The audit also found that only 57% of patients saw a specialist within two weeks despite their doctor suspecting they might have cancer. A Government pledge says patients have the right to be seen within this timeframe if their doctor suspects they have the disease.
Overall, 46% of patients saw their GP with symptoms once before being referred to a specialist. But 20% had to go to their GP twice before they were referred, 8% went three times, 3% went four times and 4% went five or more times.
More than 20% of patients with cancers of the lung, ovary, pancreas, lymphoma, myeloma and stomach had to go to their GP three times or more with symptoms, according to the report by the Royal College of GPs.
The report also found some delays in writing referral letters to specialists. A delay was defined as the time between when a patient first told their GP of a possible sign or symptom of cancer and when the referral letter was sent by the doctor.
Some 57% of letters were sent within 14 days, 11% were sent within 15 to 31 days and 7.4% were sent within 32 to 62 days. Some 6.3% of letters were not sent for 63 to 182 days, while 3% were sent after 183 days.
Overall, 54% of patients with suspected cancer were referred to a specialist through the NHS' two-week urgent referral pathway while 15% were sent as a routine referral. Some 13% were referred as an emergency. Some of these will have been patients who did not visit their GP but went straight to hospital themselves.
The report involved data on almost 19,000 patients in England collected from almost 1,200 GP practices between 2009 and 2010. It is the largest and most comprehensive study of the GP practice route to cancer diagnosis, covering one in seven practices in England.
A Department of Health spokeswoman said: "Despite recent improvements in cancer care, cancer survival rates in England are still lagging behind other countries. It is widely recognised that late diagnosis of cancer is the key reason for this, which is why the early diagnosis of cancer remains a key priority.
"Our Cancer Outcomes Strategy sets out the direction for improved cancer care and aims to save an additional 5,000 lives a year. As part of this we are committing over £450 million over the next four years to increase early diagnosis."