Patient and GP experiences of pathways to diagnosis of a second primary cancer: a qualitative study.
Adult
Aged
Aged, 80 and over
Awareness
Clinical Decision-Making
Female
General Practitioners
/ psychology
Health Behavior
Help-Seeking Behavior
Humans
Male
Middle Aged
Neoplasms, Second Primary
/ diagnosis
Primary Health Care
Psychological Distress
Qualitative Research
Referral and Consultation
Scotland
Symptom Assessment
/ psychology
General practice
Pathways to diagnosis
Primary health care
Qualitative
Second primary cancer
Survivorship
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
03 May 2021
03 May 2021
Historique:
received:
21
08
2020
accepted:
22
04
2021
entrez:
4
5
2021
pubmed:
5
5
2021
medline:
11
8
2021
Statut:
epublish
Résumé
More people are surviving a first primary cancer and experiencing a second, different cancer. However, little is known about the diagnostic journeys of patients with second primary cancer (SPC). This study explores the views of patients and general practitioners (GPs) on their experiences of pathways to diagnosis of SPC, including the influence of a previous diagnosis of cancer on symptom appraisal, help-seeking and referral decisions. Qualitative interviews with patients with a SPC diagnosis and case-linked GP interviews in a Scottish primary care setting. In-depth face to face or telephone interviews were conducted, underpinned by a social constructionist approach. Interviews were transcribed and Braun and Clarke's thematic analysis undertaken. Three analysts from the research team read transcripts and developed the coding framework using QSR NVivo version 10, with input from a fourth researcher. Themes were developed from refined codes and interpreted in the context of existing literature and theory. Interviews were conducted with 23 patients (aged 43-84 years) with a SPC diagnosis, and 7 GPs. Five patient themes were identified: Awareness of SPC, symptom appraisal and help-seeking, pathways to diagnosis, navigating the healthcare system, and impact of SPC. GPs interviews identified: experience and knowledge of SPC and referrals and decision-making. Insights into the pathway to diagnosis of SPC highlights the need for increased awareness of and vigilance for SPC among patients and healthcare providers (HCPs), and emotional support to manage the psychosocial burden.
Sections du résumé
BACKGROUND
BACKGROUND
More people are surviving a first primary cancer and experiencing a second, different cancer. However, little is known about the diagnostic journeys of patients with second primary cancer (SPC). This study explores the views of patients and general practitioners (GPs) on their experiences of pathways to diagnosis of SPC, including the influence of a previous diagnosis of cancer on symptom appraisal, help-seeking and referral decisions.
METHODS
METHODS
Qualitative interviews with patients with a SPC diagnosis and case-linked GP interviews in a Scottish primary care setting. In-depth face to face or telephone interviews were conducted, underpinned by a social constructionist approach. Interviews were transcribed and Braun and Clarke's thematic analysis undertaken. Three analysts from the research team read transcripts and developed the coding framework using QSR NVivo version 10, with input from a fourth researcher. Themes were developed from refined codes and interpreted in the context of existing literature and theory.
RESULTS
RESULTS
Interviews were conducted with 23 patients (aged 43-84 years) with a SPC diagnosis, and 7 GPs. Five patient themes were identified: Awareness of SPC, symptom appraisal and help-seeking, pathways to diagnosis, navigating the healthcare system, and impact of SPC. GPs interviews identified: experience and knowledge of SPC and referrals and decision-making.
CONCLUSIONS
CONCLUSIONS
Insights into the pathway to diagnosis of SPC highlights the need for increased awareness of and vigilance for SPC among patients and healthcare providers (HCPs), and emotional support to manage the psychosocial burden.
Identifiants
pubmed: 33941114
doi: 10.1186/s12885-021-08238-0
pii: 10.1186/s12885-021-08238-0
pmc: PMC8094599
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
496Subventions
Organisme : Cancer Research UK
ID : C12357/A21326
Pays : United Kingdom
Références
BMC Cancer. 2014 Apr 18;14:272
pubmed: 24742063
Br J Cancer. 2015 Mar 31;112 Suppl 1:S41-9
pubmed: 25734388
Psychooncology. 2006 Apr;15(4):306-20
pubmed: 16041841
Br J Cancer. 2015 Mar 31;112 Suppl 1:S92-107
pubmed: 25734382
Sociol Health Illn. 1982 Jul;4(2):167-82
pubmed: 10260456
Gynecol Oncol. 2015 Jan;136(1):158-71
pubmed: 25448459
Acta Oncol. 2007;46(4):417-32
pubmed: 17497308
BMJ. 2006 Apr 22;332(7547):942-8
pubmed: 16597660
Psychooncology. 2019 May;28(5):1041-1047
pubmed: 30828881
Health (London). 2010 Mar;14(2):178-95
pubmed: 20164165
Scand J Prim Health Care. 2012 Sep;30(3):135-40
pubmed: 22747066
Br J Cancer. 2009 Dec 3;101 Suppl 2:S80-6
pubmed: 19956169
Am Psychol. 2015 Feb-Mar;70(2):119-33
pubmed: 25730719
Patient Educ Couns. 2011 Oct;85(1):74-8
pubmed: 21036507
Cancer Epidemiol. 2016 Apr;41:34-41
pubmed: 26797675
Br J Gen Pract. 2013 Sep;63(614):e627-35
pubmed: 23998843
Br J Gen Pract. 2011 Mar;61(584):197-9
pubmed: 21375904
Lancet Oncol. 2015 Sep;16(12):1231-72
pubmed: 26431866
Fam Pract. 2011 Dec;28(6):647-54
pubmed: 21693683
Br J Cancer. 2012 Jan 3;106(1):1-5
pubmed: 22215103
BMC Cancer. 2011 Feb 23;11:83
pubmed: 21342533
Cancer. 2013 Sep 1;119(17):3140-7
pubmed: 23856984
CMAJ. 2012 Apr 17;184(7):E373-82
pubmed: 22431898
Oncologist. 2007 Jan;12(1):20-37
pubmed: 17227898
Br J Cancer. 2009 Dec 3;101 Suppl 2:S31-9
pubmed: 19956160
J Health Serv Res Policy. 2012 Apr;17(2):110-8
pubmed: 22008712
Med Educ. 2017 Jan;51(1):40-50
pubmed: 27981658
Asian Pac J Cancer Prev. 2012;13(2):671-6
pubmed: 22524843
Lancet Oncol. 2012 Apr;13(4):353-65
pubmed: 22365494
Semin Oncol. 2013 Dec;40(6):676-89
pubmed: 24331190
J Natl Cancer Inst. 2006 Jan 4;98(1):15-25
pubmed: 16391368
BMC Fam Pract. 2013 Aug 07;14:112
pubmed: 23919296
J Clin Oncol. 2012 Oct 20;30(30):3734-45
pubmed: 23008293
Cancer Nurs. 2011 Nov-Dec;34(6):487-94
pubmed: 21242763
BMC Cancer. 2019 Jun 14;19(1):586
pubmed: 31200676
Support Care Cancer. 2012 Sep;20(9):2033-40
pubmed: 22076620
Lancet. 2005 Sep 3-9;366(9488):825-31
pubmed: 16139657