A systematic review examining reducing unplanned hospital admissions in adults with cancer

Review question:1.What interventions have been tested and have successfully reduced unplanned hospital admissions in adults with cancer?2.What are the factors associated with unplanned hospital admissions in adults with cancer

A qualitative exploration of women's perspectives and acceptability of including new cancer awareness information in all‐clear breast or cervical screening results

Objective: This study explored women's perspectives on the acceptability of including new cancer information with an all-clear breast or cervical screening result letter (using ovarian cancer as a case study). Methods: In 2016, six focus group discussions were conducted with women aged 25–70 years old, eligible for invitation to the NHS breast or cervical screening programme and resident in England. The focus groups lasted 60–90 min and were held in community venues. Data were analysed using thematic analysis. Results: Thirty-eight women aged 25–67 years old participated in the focus groups. Data analysis yielded six descriptive themes: general cancer awareness, taking advantage of a ‘teachable moment’, a double-edge sword, barriers to accepting and using new cancer information, motivators for accepting and using new cancer information and wider strategies to increase cancer awareness in women. Women welcomed the inclusion of new cancer information in all-clear screening results but highlighted pertinent lessons to be considered to maximise the usefulness of the approach. Conclusion: While women perceived this approach as acceptable, it is pertinent to note the potential of the new cancer information to stimulate anxiety and potentially widen inequalities by excluding non-attenders at screening programmes. Specific complementary and tailored approaches are necessary to mitigate these limitations

An integrated understanding of the complex drivers of emergency presentations and admissions in cancer patients: qualitative modelling of secondary-care health professionals’ experiences and views

The number of cancer-related emergency presentations and admissions has been steadily increasing in the UK. Drivers of this phenomenon are complex, multifactorial and interlinked. The main objective of this study was to understand the complexity of emergency hospital use in cancer patients. We conducted semi-structured interviews with 42 senior clinicians (20 doctors, 22 nurses) with diverse expertise and experience in caring for acutely ill cancer patients in the secondary care setting. Data analysis included thematic analysis and purposive text analysis to develop Causal Loop Diagrams. Our Causal Loop Diagrams represent an integrated understanding of the complex factors (13) influencing emergency hospital use in cancer patients. Eight factors formed five reinforcing feedback loops and therefore were high-leverage influences: Ability of patients and carers to self-care and cope; Effective and timely management of ambulatory care sensitive conditions by primary and community care; Sufficient and effective social care for patients and carers; Avoidable emergency hospital use; Bed capacity; Patients accessing timely appropriate specialist inpatient or ambulatory care; Prompt and effective management and prevention of acute episode; Timely and safe discharge with appropriate support. The loops show that reduction of avoidable hospital use helps relieve hospital bed pressure; improved bed capacity then has a decisive, positive influence on patient pathway and thus outcome and experience in the hospital; in turn, better in-hospital care and discharge help patients and carers self-care and cope better back home with better support from community-based health and social care services, which then reduces their future emergency hospital use. To optimise acute and emergency cancer care, it is also essential that patients, carers and other clinicians caring for cancer patients have prompt access to senior cancer specialists for advice, assessment, clinical decision and other support. The findings provide a useful framework and focus for service planners aiming to optimise care

Experience of, awareness of and help-seeking for potential cancer symptoms in smokers and non-smokers: A cross-sectional study

Background Presenting to primary care with potential cancer symptoms is contingent on one’s ability to recognize potentially serious symptoms. We investigated differences between smokers and non-smokers in symptoms experienced, awareness and consulting of potential respiratory, head and neck cancer symptoms. Methods Smokers and non-smokers aged over 50 from Yorkshire general practice lists were sent a postal questionnaire asking about symptoms, consulting and awareness of cancer symptoms. Data were analysed using STATA14. Results Response rate after one reminder was 30.5% (1205/3954). Smoking status was associated with experience of cough (p<0.001), breathlessness (p = 0.002) and tiredness (p = 0.004) with smokers (25.8% of population) more likely than never-smokers (53.6% of population) to experience all three symptoms (cough OR = 2.56;95%CI[1.75–3.75], breathlessness OR = 2.39;95%CI[1.43–4.00], tiredness OR = 1.57;95%CI[1.12–2.19]). Smoking status was associated with awareness of breathlessness as a potential cancer symptom (p = 0.035) and consulting for cough (p = 0.011) with smokers less likely to consult than never-smokers (OR = 0.37;95% CI[0.17–0.80]). Conclusion Our findings suggest that current smokers are more likely to experience cough, breathlessness and tiredness, but are less likely to consult for cough than never-smokers. To increase cancer awareness and promote consulting among smokers, innovative interventions improving symptom recognition and empowering smokers to seek help are required

The PEOPLE-HULL Study: improving help-seeking for lung symptoms in Hull. Trial registration.

Background and study aims:More people are diagnosed with and die from lung cancer in Hull than any other place in Yorkshire. The main reason for this is related to lung cancers being diagnosed at a time when they are too advanced to be eligible for curative treatment. The aim of this study is to improve earlier diagnosis of lung cancer by encouraging people to see their doctor if they get lung symptoms and supporting GPs to refer people sooner

Does socio-demographic profile influence awareness of potential symptoms for lung or head and neck cancers in adults over 50?

In terms of morbidity and mortality, cancer remains a significant health problem in the United Kingdom, which has led to significant interest in both patients and professionals recognising cancer symptoms. Some studies have argued that socio-demographic inequalities may be partly responsible for differences in when cancer is diagnosed and survival. This suggests the need for improved awareness of cancer symptoms to facilitate early diagnosis and better survival, especially in marginalised and disadvantaged groups. Although there is evidence of an association between socio-economic status (SES) and the awareness of general cancer symptoms by patients, no studies have examined differences in the awareness of respiratory or head and neck cancer symptoms among people who have not yet been diagnosed with cance

Experience of, awareness of and help-seeking for potential cancer symptoms in smokers and non-smokers: a cross-sectional study

Abstract Background: Presenting to primary care with potential cancer symptoms is contingent on one’s ability to recognize potentially serious symptoms. We investigated differences between smokers and non-smokers in symptoms experienced, awareness and consulting of potential respiratory, head and neck cancer symptoms. Methods: Smokers and non-smokers aged over 50 from Yorkshire general practice lists were sent a postal questionnaire asking about symptoms, consulting and awareness of cancer symptoms. Data were analysed using STATA14. Results: Response rate after one reminder was 30.5% (1205/3954). Smoking status was associated with experience of cough (p<0.001), breathlessness (p=0.002) and tiredness (p=0.004) with smokers (25.8% of population) more likely than never-smokers (53.6% of population) to experience all three symptoms (cough OR=2.56;95%CI[1.75-3.75], breathlessness OR=2.39;95%CI[1.43-4.00], tiredness OR=1.57;95%CI[1.12-2.19]). Smoking status was associated with awareness of breathlessness as a potential cancer symptom (p=0.035) and consulting for cough (p=0.011) with smokers less likely to consult than never-smokers (OR=0.37;95% CI[0.17-0.80]). Conclusion: Our findings suggest that current smokers are more likely to experience cough, breathlessness and tiredness, but are less likely to consult for cough than never-smokers. To increase cancer awareness and promote consulting among smokers, innovative interventions improving symptom recognition and empowering smokers to seek help are required

Sample characteristics, frequencies and association with smoking.

<p>Sample characteristics, frequencies and association with smoking.</p

Frequencies for symptoms experience, self-reported consulting and awareness of cough, breathlessness, tiredness and shoulder pain and the association with smoking status.

<p>Frequencies for symptoms experience, self-reported consulting and awareness of cough, breathlessness, tiredness and shoulder pain and the association with smoking status.</p

Symptom experience, cancer awareness, consulting and smoking status dataset.xlsx

<p>This is the 'minimal data set' comprising the variables used to obtain the conclusions drawn in the PLOS One manuscript: 'Experience of, awareness of and help-seeking for potential cancer symptoms in smokers and non-smokers' Walabyeki, J; Adamson, J; Atkin, K ;Buckley, H; Sinclair, H; Whitaker, K; Graham, H; Wardle, J; Macleod, U. (accepted manuscript). The data set was obtained from a postal survey sent by the general practices to cancer-free people over 50 years old. The participants also provided their smoking status information and the amount smoked. For further information contact: <a href="mailto:[email protected]">[email protected]</a> </p