Exploring Service User and practitioner perspectives of QCancer use in primary care consultations

Problem

QCancer is a novel cancer risk assessment tool that combines risk factors and symptoms to estimate an individual’s risk of developing cancer within two years. The evidence about service user and practitioner perspectives of QCancer use in primary care is limited. This study explored the perspectives of service users and primary care practitioners about using QCancer in the primary care consultation.

Approach

We used qualitative methods to conduct individual and focus group interviews with service users recruited from the general public and primary care practitioners (GPs and nurses) recruited from general practices in Lincolnshire (a large rural county in England) until data saturation was reached. The qualitative data were transcribed verbatim and analysed using the framework approach.

Findings

Thirty-six participants, 19 service users and 17 practitioners, were interviewed. They expressed a range of views about the implications of quantifying cancer risk using QCancer. These implications include: potential conflict with current cancer guidelines and the need for patients with symptoms suggestive of cancer to be referred for further investigation whatever the quantified risk.Participants (service users and practitioners) agreed that QCancer would be useful for consultations for cancer in terms of: quantifying risk; supporting decision-making; identifying, raising awareness of and modifying health behaviours; improving processes and speed of assessment and treatment; and personalising care.Participants also raised the need to address communication issues related to use of QCancer such as tailoring visual representation of risk; openness and honesty; informing and involving patients in use of QCancer and providing time for listening, informing, explaining and reassuring in the context of a professional approach. Participants also identified potential challenges to uptake of QCancer in general practice including: additional time required, unnecessary worry generated by false positives, potential for over-referral, practitioner scepticism about using the new tool, and the need for evidence of effectiveness before introducing QCancer in patient consultations.

Consequences

Service users and primary care practitioners perceived that QCancer would support and individualise decision making, help identify and modify health behaviours, improve the processes and speed of cancer assessments and treatments and facilitate personalised care of cancer. Communication needs of users and potential barriers for both users and practitioners will need to be considered in planning for QCancer use in general practice consultations.