Abstract

SAPC ASM Conference, Warwick 2017
Exploring service user and practitioner perspectives of using cancer risk assessment tools in primary care GP consultations

Authors: Joseph Akanuwe, Dr Sharon Black, Prof Sara Owen & Prof Niro Siriwardena

Introduction
The UK has one of the highest cancer mortality rates in Europe. The high mortality may be due to late presentation or detection of symptoms in primary care. Cancer Risk Assessment Tools e.g. RAT and QCancer combine risk factors and symptoms to estimate an individual’s risk of developing cancer within two or more years.

The tools are integrated in the GP IT systems e.g SystomOne, EMIS and Vision+, and GPs are encouraged to use them. However, evidence about the use of cancer risk assessment tools is limited. For example, there is limited evidence on how best cancer risk information can be communicated to patients. Knowledge about the facilitators and barriers to implementation of the tools is also not clear. We aimed to explore the views of service users and primary care practitioners about how best to communicate cancer risk information to patients when using cancer risk assessment tools in patient consultations. The facilitators and barriers to implementation of the tools were also explored.

Methods
We used individual and focus group interviews to collect qualitative data from 36 participants (19 service users recruited from the general public and 17 practitioners) recruited from Lincolnshire general practices. The data were transcribed verbatim and analysed using the Framework approach.

Results
Participants identified ways to better communicate risk information including: tailoring a visual representation of risk; providing time for informing, listening, explaining and reassuring in a professional manner; being open and honest and involving patients when using cancer risk assessment tools.

The facilitators to implementation identified included: aiding decision making; improving processes, speed of assessment and treatment; identifying and modifying health risk behaviours and personalising care. The barriers to implementation included: additional consultation time, worry or anxiety, practitioner scepticism and the need to establish effectiveness of cancer risk assessment tools as compared to existing practice.

Conclusion
We found ways to better communicate cancer risk information to patients. Facilitators and barriers to implementation of cancer risk assessment tools were also identified. Further research is needed to establish effectiveness of cancer risk assessment tools and the experiences of patients and practitioners on using the tools.