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.

Figure 1

Diagrammatic representation of themes emerging from responses to the question “How do you think the speed of diagnosis of cancer in primary care could be improved?” PCP, primary care practitioner.