The early diagnosis of cancer in primary care: A qualitative exploration of the patient's role and acceptable safety-netting strategies

Eur J Cancer Care (Engl). 2020 Jan;29(1):e13195. doi: 10.1111/ecc.13195. Epub 2019 Dec 12.

Abstract

Objectives: The study had two aims-to assess the components considered important for patient involvement in diagnosing cancer earlier in primary care and to assess the acceptability, feasibility, cost and burden of three safety-netting interventions in terms of their potential to become a sustainable component of standard care and improve diagnostic outcomes for cancer in a primary care setting.

Method: Fifteen interviews were conducted with patients and GPs/Nurse Practitioners. Findings were fed back at a workshop with 18 stakeholders who helped to conceptualise an intervention. Interviews were analysed using thematic analysis. Stakeholder discussions were captured through group feedback sessions.

Results: Three key themes around stakeholders' views on patient involvement emerged from the interviews. These were keeping the door open, roles and responsibilities and fear of cancer. Interview findings and workshop feedback identified the intervention should include a verbal discussion and plan, written information and a patient prompt option.

Conclusion: Patient involvement in diagnosing cancer in primary care is considered acceptable to patients and HCPs. Factors that facilitate or hinder involvement have been identified. Components deemed important in a safety-netting intervention, and potential costs and benefits were established. This knowledge can direct future research and the development of safety-netting interventions.

Keywords: cancer; diagnosis; patient involvement; primary health care; safety-netting.

MeSH terms

  • Adult
  • Aged
  • Early Detection of Cancer*
  • Female
  • General Practitioners
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / diagnosis*
  • Nurse Practitioners
  • Patient Acceptance of Health Care*
  • Patient Education as Topic
  • Patient Participation*
  • Primary Health Care*
  • Qualitative Research
  • Role*