Cancer detection in primary care: insights from general practitioners

Abstract

Background:General practitioners (GPs) have a key role in cancer detection as the usual first point of contact for patients with potential cancer symptoms. Nevertheless, there is limited work that investigates their perceptions of their role in the early detection of cancer. To address this gap, we aimed to gain an in-depth understanding of cancer diagnosis from the perspective of GPs.Methods:Individual face-to-face semi-structured interviews were conducted with 55 GPs from the North and North East of England and Greater London. All interviews were recorded and professionally transcribed verbatim. Repeated reading and co-coding engendered systematic thematic analysis across the interview material.Results:Three main themes emerged from the analysis of our data. First, we identified the burden of early cancer detection in general practice, both related to the anxiety and symptoms patients bring to GPs and the need for GPs to recognise patterns of cancer symptoms and refer appropriately; second, this burden is intensified by a perceived fragmentation of services within the National Health Service (NHS); and third, it is made more complex by the interface between general practice and public health.Conclusions:GPs occupy a challenging but pivotal role in cancer detection. It is crucial that this role be supported by policy and research.

Facilitating early diagnosis of lung cancer amongst primary care patients: The views of GPs

“…Limited work has previously investigated GP's views of their own role in early detection (Green, Atkin, & Macleod, 2015). This study conducted focus groups with GPs from participating general practice sites to elicit their views with regards facilitating targeted interventions.…”

“…Although the "3-week cough campaign" led to a 9% increase in lung cancer diagnoses compared with the same period in the previous year (Ironmonger et al, 2015), there was a corresponding increase of >200,000 additional GP attendances and 30% increase in 2-week waits recorded (PULSE 2014). Evidence also indicates such increases are particularly apparent in affluent rather than deprived areas (Green et al, 2015).…”

Preventing delayed diagnosis of cancer: clinicians’ views on main problems and solutions

“…Although existing research identifies a number of contributing factors to delayed cancer diagnosis, it is unclear which patient safety interventions would have the highest yield and should be given precedence. Clinicians offer unmatched, first–hand insight into the health care service delivery and can help in establishing a consensus on priorities for timely cancer diagnosis [9–11]. Furthermore, clinicians’ engagement is essential for successful implementation of patient safety interventions.…”

GPs’ perceptions and experiences of public awareness campaigns for cancer: a qualitative enquiry

“…The majority of GPs in England will encounter a cancer diagnosis quite rarely in comparison with the numbers of symptoms patients might present with that could be suggestive of the disease . Detecting cancer therefore takes up much GP time . There is some evidence to indicate that time to diagnosis can be reduced by involving both patients and GPs in any awareness raising activity, so that both are primed to act and as we have demonstrated, GP inclusion was evident in public health campaigns on‐going at the time of our study.…”