Physician perspectives on delays in cancer diagnosis in Alberta: a qualitative study.

Autor: Botey AP; Cancer Strategic Clinical Network (Pujadas Botey, Stewart), Alberta Health Services, Calgary, Alta.; School of Public Health (Pujadas Botey), University of Alberta, Edmonton, Alta.; Independent health services researcher (GermAnn), Lacombe County, Alta.; Cancer Strategic Clinical Network (Robon, O'Neill), Alberta Health Services, Edmonton, Alta.; Cancer Care Alberta (Robson), Alberta Health Services, Edmonton, Alta.; Departments of Oncology and Medicine (Stewart), University of Calgary, Calgary, Alta. Anna.PujadasBotey@ahs.ca., GermAnn K; Cancer Strategic Clinical Network (Pujadas Botey, Stewart), Alberta Health Services, Calgary, Alta.; School of Public Health (Pujadas Botey), University of Alberta, Edmonton, Alta.; Independent health services researcher (GermAnn), Lacombe County, Alta.; Cancer Strategic Clinical Network (Robon, O'Neill), Alberta Health Services, Edmonton, Alta.; Cancer Care Alberta (Robson), Alberta Health Services, Edmonton, Alta.; Departments of Oncology and Medicine (Stewart), University of Calgary, Calgary, Alta., Robson PJ; Cancer Strategic Clinical Network (Pujadas Botey, Stewart), Alberta Health Services, Calgary, Alta.; School of Public Health (Pujadas Botey), University of Alberta, Edmonton, Alta.; Independent health services researcher (GermAnn), Lacombe County, Alta.; Cancer Strategic Clinical Network (Robon, O'Neill), Alberta Health Services, Edmonton, Alta.; Cancer Care Alberta (Robson), Alberta Health Services, Edmonton, Alta.; Departments of Oncology and Medicine (Stewart), University of Calgary, Calgary, Alta., O'Neill BM; Cancer Strategic Clinical Network (Pujadas Botey, Stewart), Alberta Health Services, Calgary, Alta.; School of Public Health (Pujadas Botey), University of Alberta, Edmonton, Alta.; Independent health services researcher (GermAnn), Lacombe County, Alta.; Cancer Strategic Clinical Network (Robon, O'Neill), Alberta Health Services, Edmonton, Alta.; Cancer Care Alberta (Robson), Alberta Health Services, Edmonton, Alta.; Departments of Oncology and Medicine (Stewart), University of Calgary, Calgary, Alta., Stewart DA; Cancer Strategic Clinical Network (Pujadas Botey, Stewart), Alberta Health Services, Calgary, Alta.; School of Public Health (Pujadas Botey), University of Alberta, Edmonton, Alta.; Independent health services researcher (GermAnn), Lacombe County, Alta.; Cancer Strategic Clinical Network (Robon, O'Neill), Alberta Health Services, Edmonton, Alta.; Cancer Care Alberta (Robson), Alberta Health Services, Edmonton, Alta.; Departments of Oncology and Medicine (Stewart), University of Calgary, Calgary, Alta.
Jazyk: angličtina
Zdroj: CMAJ open [CMAJ Open] 2021 Nov 30; Vol. 9 (4), pp. E1120-E1127. Date of Electronic Publication: 2021 Nov 30 (Print Publication: 2021).
DOI: 10.9778/cmajo.20210013
Abstrakt: Background: Delays in cancer diagnosis have been associated with reduced survival, decreased quality of life after treatment, and suboptimal patient experience. The objective of the study was to explore the perspectives of a group of family physicians and other specialists regarding potentially avoidable delays in diagnosing cancer, and approaches that may help expedite the process.
Methods: We conducted a qualitative study using interviews with physicians practising in primary and outpatient care settings in Alberta between July and September 2019. We recruited family physicians and specialists who were in a position to discuss delays in cancer diagnosis by email via the Cancer Strategic Clinical Network and the Alberta Medical Association. We conducted semistructured interviews over the phone, and analyzed data using thematic analysis.
Results: Eleven family physicians and 22 other specialists (including 7 surgeons or surgical oncologists, 3 pathologists, 3 radiologists, 2 emergency physicians and 2 hematologists) participated in interviews; 22 were male (66.7%). We identified 4 main themes describing 9 factors contributing to potentially avoidable delays in diagnosis, namely the nature of primary care, initial presentation, investigation, and specialist advice and referral. We also identified 1 theme describing 3 suggestions for improvement, including system integration, standardized care pathways and a centralized advice, triage and referral support service for family physicians.
Interpretation: These findings suggest the need for enhanced support for family physicians, and better integration of primary and specialty care before cancer diagnosis. A multifaceted and coordinated approach to streamlining cancer diagnosis is required, with the goals of enhancing patient outcomes, reducing physician frustration and optimizing efficiency.
Competing Interests: Competing interests: Anna Pujadas Botey, Kathy GermAnn, Paula Robson and Barbara O’Neill report support from Alberta Health Services. Paula Robson also reports her role as board chair of the Canadian Cancer Research Alliance.
(© 2021 CMA Joule Inc. or its licensors.)
Databáze: MEDLINE
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