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

a thematic analysis

Michael Harris (Corresponding Author), 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, 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
Number of pages9
JournalBMJ Open
Volume9
Issue number9
Early online date24 Sep 2019
DOIs
Publication statusPublished - 2019

Fingerprint

Primary Health Care
Neoplasms
Technology
Secondary Care
Continuing Medical Education
Health
Early Detection of Cancer
Health Education
Routine Diagnostic Tests
Survival Rate
Communication
Delivery of Health Care
Education

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Harris, M., Thulesius, H., Neves, A. L., Harker, S., Koskela, T., Petek, D., ... Esteva, M. (2019). How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis. BMJ Open, 9(9), [e030169]. https://doi.org/10.1136/bmjopen-2019-030169

How European primary care practitioners think the timeliness of cancer diagnosis can be improved : a thematic analysis. / Harris, Michael (Corresponding Author); 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, 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, 2019.

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, G-J, Foreva, G, Jakob, E, Marzo, 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. 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, 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.
@article{690ea68064ce47198c02e49af4172924,
title = "How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis",
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.",
keywords = "Cancer, Consultation and Referral, Delivery of Health Care, Diagnosis, General Practitioners, Primary Health Care",
author = "Michael Harris and Hans Thulesius and Neves, {Ana Lu{\'i}sa} and Sophie Harker and Tuomas Koskela and Davorina Petek and Robert Hoffman and Mette Brekke and Krzysztof Buczkowski and Nicola Buono and Emiliana Costiug and Geert-Jan Dinant and Gergana Foreva and Eva Jakob and Merc{\`e} Marzo and Peter Murchie and Jolanta Sawicka-Powierza and Antonius Schneider and Emmanouil Smyrnakis and Sven Streit and Gordon Taylor and Peter Vedsted and Birgitta Weltermann and Magdalena Esteva",
note = "Acknowledgments The authors would like to thank all the PCPs who piloted the questionnaire and those who completed the survey. The authors would also like to thank the following non-author contributors: Isabelle Aubin-Auger (Universit{\'e} Paris Diderot, Paris, France), Joseph Azuri (Tel Aviv University, Tel Aviv, Israel), Svjetlana Gašparović Babić (The Teaching Institute of Public Health of Primorsko-goranska County, Rijeka, Croatia) and Marija Petek Šter (University of Ljubljana, Ljubljana, Slovenia). Funding: This study received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. ALN is supported by the National Institute for Health Research (NIHR) Imperial Patient Safety Translation Research Centre, with infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC).",
year = "2019",
doi = "10.1136/bmjopen-2019-030169",
language = "English",
volume = "9",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "9",

}

TY - JOUR

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, 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 - Acknowledgments The authors would like to thank all the PCPs who piloted the questionnaire and those who completed the survey. The authors would also like to thank the following non-author contributors: Isabelle Aubin-Auger (Université Paris Diderot, Paris, France), Joseph Azuri (Tel Aviv University, Tel Aviv, Israel), Svjetlana Gašparović Babić (The Teaching Institute of Public Health of Primorsko-goranska County, Rijeka, Croatia) and Marija Petek Šter (University of Ljubljana, Ljubljana, Slovenia). Funding: This study received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. ALN is supported by the National Institute for Health Research (NIHR) Imperial Patient Safety Translation Research Centre, with infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC).

PY - 2019

Y1 - 2019

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.

AB - 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.

KW - Cancer

KW - Consultation and Referral

KW - Delivery of Health Care

KW - Diagnosis

KW - General Practitioners

KW - Primary Health Care

UR - http://www.scopus.com/inward/record.url?scp=85072596947&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2019-030169

DO - 10.1136/bmjopen-2019-030169

M3 - Article

VL - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 9

M1 - e030169

ER -