Patient and GP experiences of pathways to diagnosis of a second primary cancer: a qualitative study

Debbie Cavers, Christine Campbell, David Brewster, David Weller, Annemieke Bikker, Lovney Kanguru, Karen Barnett, Rhona Duff

Research output: Contribution to journalArticlepeer-review

Abstract

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
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
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
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.
Original languageEnglish
Article number496
JournalBMC Cancer
Volume21
Issue number496
Early online date3 May 2021
DOIs
Publication statusE-pub ahead of print - 3 May 2021

Keywords

  • Qualitative
  • second primary cancer
  • pathways to diagnosis
  • Early detection
  • SURVIVORSHIP

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