How European primary care practitioners think the timeliness of cancer diagnosis can be improved

A thematic analysis

Michael Harris, Hans Thulesius, Ana Luísa Neves, Sophie Harker, Tuomas Koskela, Davorina Petek, Robert Hoffman, Mette Brekke, Krzysztof Buczkowski, Nicola Buono, Emiliana Costiug, Geert Jan Dinant, Gergana Foreva, Eva Jakob, Mercè Marzo-Castillejo, Peter Murchie, Jolanta Sawicka-Powierza, Antonius Schneider, Emmanouil Smyrnakis, Sven Streit & 4 others Gordon Taylor, Peter Vedsted, Birgitta Weltermann, Magdalena Esteva

Research output: Contribution to journalArticle

Abstract

BACKGROUND: National European cancer survival rates vary widely. Prolonged diagnostic intervals are thought to be a key factor in explaining these variations. Primary care practitioners (PCPs) frequently play a crucial role during initial cancer diagnosis; their knowledge could be used to improve the planning of more effective approaches to earlier cancer diagnosis.

OBJECTIVES: This study sought the views of PCPs from across Europe on how they thought the timeliness of cancer diagnosis could be improved.

DESIGN: In an online survey, a final open-ended question asked PCPs how they thought the speed of diagnosis of cancer in primary care could be improved. Thematic analysis was used to analyse the data.

SETTING: A primary care study, with participating centres in 20 European countries.

PARTICIPANTS: A total of 1352 PCPs answered the final survey question, with a median of 48 per country.

RESULTS: The main themes identified were: patient-related factors, including health education; care provider-related factors, including continuing medical education; improving communication and interprofessional partnership, particularly between primary and secondary care; factors relating to health system organisation and policies, including improving access to healthcare; easier primary care access to diagnostic tests; and use of information technology. Re-allocation of funding to support timely diagnosis was seen as an issue affecting all of these.

CONCLUSIONS: To achieve more timely cancer diagnosis, health systems need to facilitate earlier patient presentation through education and better access to care, have well-educated clinicians with good access to investigations and better information technology, and adequate primary care cancer diagnostic pathway funding.

Original languageEnglish
Article numbere030169
Pages (from-to)1-10
Number of pages10
JournalBMJ Open
Volume9
Issue number9
Early online date24 Sep 2019
DOIs
Publication statusPublished - 24 Sep 2019

Keywords

  • Cancer
  • Consultation and Referral
  • Delivery of Health Care
  • Diagnosis
  • General Practitioners
  • Primary Health Care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

How European primary care practitioners think the timeliness of cancer diagnosis can be improved : A thematic analysis. / Harris, Michael; Thulesius, Hans; Neves, Ana Luísa; Harker, Sophie; Koskela, Tuomas; Petek, Davorina; Hoffman, Robert; Brekke, Mette; Buczkowski, Krzysztof; Buono, Nicola; Costiug, Emiliana; Dinant, Geert Jan; Foreva, Gergana; Jakob, Eva; Marzo-Castillejo, Mercè; Murchie, Peter; Sawicka-Powierza, Jolanta; Schneider, Antonius; Smyrnakis, Emmanouil; Streit, Sven; Taylor, Gordon; Vedsted, Peter; Weltermann, Birgitta; Esteva, Magdalena.

In: BMJ Open, Vol. 9, No. 9, e030169, 24.09.2019, p. 1-10.

Research output: Contribution to journalArticle

Harris, M, Thulesius, H, Neves, AL, Harker, S, Koskela, T, Petek, D, Hoffman, R, Brekke, M, Buczkowski, K, Buono, N, Costiug, E, Dinant, GJ, Foreva, G, Jakob, E, Marzo-Castillejo, M, Murchie, P, Sawicka-Powierza, J, Schneider, A, Smyrnakis, E, Streit, S, Taylor, G, Vedsted, P, Weltermann, B & Esteva, M 2019, 'How European primary care practitioners think the timeliness of cancer diagnosis can be improved: A thematic analysis', BMJ Open, vol. 9, no. 9, e030169, pp. 1-10. https://doi.org/10.1136/bmjopen-2019-030169
Harris, Michael ; Thulesius, Hans ; Neves, Ana Luísa ; Harker, Sophie ; Koskela, Tuomas ; Petek, Davorina ; Hoffman, Robert ; Brekke, Mette ; Buczkowski, Krzysztof ; Buono, Nicola ; Costiug, Emiliana ; Dinant, Geert Jan ; Foreva, Gergana ; Jakob, Eva ; Marzo-Castillejo, Mercè ; Murchie, Peter ; Sawicka-Powierza, Jolanta ; Schneider, Antonius ; Smyrnakis, Emmanouil ; Streit, Sven ; Taylor, Gordon ; Vedsted, Peter ; Weltermann, Birgitta ; Esteva, Magdalena. / How European primary care practitioners think the timeliness of cancer diagnosis can be improved : A thematic analysis. In: BMJ Open. 2019 ; Vol. 9, No. 9. pp. 1-10.
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T1 - How European primary care practitioners think the timeliness of cancer diagnosis can be improved

T2 - A thematic analysis

AU - Harris, Michael

AU - Thulesius, Hans

AU - Neves, Ana Luísa

AU - Harker, Sophie

AU - Koskela, Tuomas

AU - Petek, Davorina

AU - Hoffman, Robert

AU - Brekke, Mette

AU - Buczkowski, Krzysztof

AU - Buono, Nicola

AU - Costiug, Emiliana

AU - Dinant, Geert Jan

AU - Foreva, Gergana

AU - Jakob, Eva

AU - Marzo-Castillejo, Mercè

AU - Murchie, Peter

AU - Sawicka-Powierza, Jolanta

AU - Schneider, Antonius

AU - Smyrnakis, Emmanouil

AU - Streit, Sven

AU - Taylor, Gordon

AU - Vedsted, Peter

AU - Weltermann, Birgitta

AU - Esteva, Magdalena

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/9/24

Y1 - 2019/9/24

N2 - BACKGROUND: National European cancer survival rates vary widely. Prolonged diagnostic intervals are thought to be a key factor in explaining these variations. Primary care practitioners (PCPs) frequently play a crucial role during initial cancer diagnosis; their knowledge could be used to improve the planning of more effective approaches to earlier cancer diagnosis.OBJECTIVES: This study sought the views of PCPs from across Europe on how they thought the timeliness of cancer diagnosis could be improved.DESIGN: In an online survey, a final open-ended question asked PCPs how they thought the speed of diagnosis of cancer in primary care could be improved. Thematic analysis was used to analyse the data.SETTING: A primary care study, with participating centres in 20 European countries.PARTICIPANTS: A total of 1352 PCPs answered the final survey question, with a median of 48 per country.RESULTS: The main themes identified were: patient-related factors, including health education; care provider-related factors, including continuing medical education; improving communication and interprofessional partnership, particularly between primary and secondary care; factors relating to health system organisation and policies, including improving access to healthcare; easier primary care access to diagnostic tests; and use of information technology. Re-allocation of funding to support timely diagnosis was seen as an issue affecting all of these.CONCLUSIONS: To achieve more timely cancer diagnosis, health systems need to facilitate earlier patient presentation through education and better access to care, have well-educated clinicians with good access to investigations and better information technology, and adequate primary care cancer diagnostic pathway funding.

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KW - Consultation and Referral

KW - Delivery of Health Care

KW - Diagnosis

KW - General Practitioners

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