Incorporating cancer risk information into general practice: a qualitative study using focus groups with healthcare professionals


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Juliet Usher-Smith1,Barbora Silarova1,Alison Ward2,Jane Youell2,Kenneth Muir3,Jackie Campbell2,Joanne Warcaba4
1University of Cambridge,2University of Northampton,3University of Manchester,4Moulton Surgery, Northampton

Abstract

Background

It is estimated that approximately 40% of all cases of cancer are attributable to lifestyle factors. Providing people with personalised information about their future risk of cancer may help promote behaviour change. The aim of this study was to explore the views of healthcare professionals on incorporating personalised cancer risk information based on lifestyle factors into general practice.

Method

We held six focus groups with GPs, GP registrars, practice nurses, GP commissioners and non-clinical members of clinical commissioning groups. Each group was guided by a schedule covering current provision of lifestyle advice relating to cancer and views on incorporating personalised cancer risk information. Data were audio-recorded, transcribed verbatim and then analysed using thematic analysis.

Results

Providing lifestyle advice was generally viewed as a core activity within general practice but, with the exception of smoking and lung cancer, the influence of lifestyle on cancer risk was rarely discussed. The word ‘cancer’ was seen as a potentially powerful motivator for lifestyle change. However, the potential for discussions around cancer risk to generate health anxiety and for a high risk to lead to maladaptive behaviours was also recognised. Most felt that a numerical estimate was more likely to influence behaviour than generic information and that the focus should be on targeting younger people. All felt that general practice should be providing this information but there was a clear need for additional resources if it was going to be offered widely. These included additional funding and consultation time, referral pathways, integration into the computer system, and training.

Conclusion

There is support among healthcare professionals for providing personalised cancer risk information within general practice. The findings highlight a number of potential benefits and challenges which will inform the future development of interventions to promote behaviour change for cancer prevention in general practice.