Diagnosing myeloma in general practice: how might earlier diagnosis be achieved?

Abstract

Smith et al describe the issues with the current diagnostic process for myeloma in general practice, explore the potential impact of the COVID-19 pandemic, and identify alternative strategies that may improve the early diagnosis. Around half of myeloma patients have three or more pre-referral consultations and around one-third are diagnosed through emergency presentation. Improving the timeliness of myeloma diagnosis is vital to improving patient outcomes, but is difficult to achieve because of complex, non-specific, and varied presentations. Improving GP education on the salient features of multiple myeloma presentation and the investigations required for diagnosis, alongside ensuring adequate safety netting for patients with persistent, unexplained symptoms, should be urgent priorities. Changes to general practice consultations following the COVID-19 pandemic have made myeloma diagnosis more difficult, and, over the longer term, research is required to develop intelligent and technological strategies that support physician decision making and reduce diagnostic delay.