Patient involvement in diagnosing cancer in primary care

In a primary care setting, the patient interval rather than the primary care interval has been found to make a larger contribution to delay in 18 out of 28 cancers. Patients have a role to play in achieving an earlier diagnosis of cancer, but little is known about how patients can be engaged in monitoring and re-appraising symptoms after an initial presentation to primary care, and before a referral or a diagnosis is obtained. This systematic review aimed to identify interventions that involve patients and establish the key components for engaging patients in the diagnosis of cancer in primary care. No interventions that involved patients were found. Sixteen articles were included which provided suggestions for potential intervention and important components to involve patients  in the diagnostic process. Key factors identified were distinguishing between symptoms associated with comorbid conditions and new symptoms that may be due to cancer, and the significance of vague or non-specific symptoms and the established ‘red flag’ symptom. Issues around poor patient-HCP communication during consultation was also prominent. The logic model which was informed by the 16 studies identifies potential barriers and facilitators for engaging patients at the diagnostic stage, and could be used to inform and develop future interventions. Read the full article