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Abstract

Cancer risk assessment tools for symptomatic individuals presenting to primary care: a systematic scoping review

ABSTRACT
CANCER RISK ASSESSMENT TOOLS FOR SYMPTOMATIC INDIVIDUALS PRESENTING TO PRIAMRY CARE: A SYSTEMATIC SCOPING REVIEW

Background: Novel cancer risk assessment tools, designed to predict cancer risk in symptomatic individuals in primary care settings, are being advocated to address the problem of late diagnosis of cancer in the UK. Despite this, little is known about the use and implementation of cancer risk assessment tools to aid early detection of cancer risk in general practice. We aimed to scope the evidence on the type of cancer risk assessment tools available for symptomatic individuals, and the current use of the tools including the benefits and barriers to their use.

Methods: Using Arksey and O’Malley’s framework, we conducted a systematic scoping review of published literature in the English language from 2004 to 2017. We searched six electronic databases (Medline, CINAHL, Scopus, Cochrane, Science Direct and Psych-INFO) using specific search terms. A narrative synthesis was used to summarise the findings from the studies identified.

Results: We retrieved a total of 471 papers from the electronic databases and 43 matched the inclusion criteria. Novel cancer risk assessment tools for symptomatic individuals in primary care identified from the review included the QCancer and RAT series. While there was some evidence supporting use of some of the tools, there was limited evidence on the current use and the impact of using the tools on patient outcomes such as rates of cancer diagnosis and survival. There was also some evidence on potential benefits (potential aid for clinicians to confirm investigations and referral decisions, for reassurance of patients when investigation not needed, helping GPs to recognise symptoms of some cancers and useful for detecting cancer risk in patients with complex histories) and barriers to using the tools in primary care consultations. As the review found, the following barriers to use of the tools would need to be addressed for effective implementation of the tools in primary care: how to make the tools available to clinicians, how best to communicate cancer risk information to patients, uncertainty about the threshold for action to be taken, extra consultation time requirement, potential for causing alarm to patients, potential burden on resources, a challenge about integrating the tools into general practice workflow and a potential for ‘prompt fatigue.

Conclusion: The review revealed evidence of novel cancer risk assessment tools designed for symptomatic individuals in primary care. There was also evidence on potential benefits and barriers relating to the use of the tools. There is a need to address the barriers identified when implementing the tools in general consultations.

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• Cancer risk assessment tools for symptomatic individuals presenting to primary care: a systematic scoping review. (deposited 19 Feb 2019 12:09)
  • Cancer risk assessment tools for symptomatic individuals presenting to primary care: a systematic scoping review. (deposited 08 Mar 2019 08:26) [Currently Displayed]