Table 1 Vignettes for simulated consultations

Case one

You are a 55 year old woman and you have had no serious illnesses in the past.

For the past few weeks you have felt bloated and that your tummy seemed bigger than usual. You feel a bit constipated but you have had no bleeding or any other bowel symptoms. Your weight is steady and you have felt a bit more tired than usual but you have been working longer hours recently. You have also been getting some indigestion after meals. You have no other symptoms.

Your mother had breast cancer in her 60s and there is no other relevant family history.

You have never smoked and drink a glass of wine 2-3 times per week. You are married and your children are away at university.

You weigh 61 kg and are 162 cm tall.

QCancer risk estimates: ovarian cancer 1.72%; colorectal cancer 0.27%

Case two

You are a 65 year old man who has had a bad cough for the last month which won’t go away. You have not coughed much up and in particular you have not coughed up any blood. You saw another GP about this a couple of weeks ago and the antibiotics he gave have made no difference.

You have also been getting indigestion and pain in your stomach (centrally just below your ribs) and have taken a few indigestion tablets from the pharmacy for it. You have lost a few kilos recently as your trousers aren’t as tight as usual. Your bowels are normal and you don’t have any other symptoms.

You have a history of diabetes for which you take tablets every day and emphysema (you are on 2 puffers)

You have smoked 10-15 cigarettes a day for many years and have a couple of beers each night.

Your wife died a few years ago of breast cancer and you live alone. Your parents and grandparents all died of ‘old age’ in their 80s.

You weigh about 105 kg and are 180 cm tall.

QCancer risk estimates: pancreatic 18.68%; gastro-oesophageal 11.98%; lung 9.70%