Patients’ views on the decision to investigate cancer symptoms in older adults: a qualitative interview study in primary care

Patients’ views on the decision to investigate cancer symptoms in older adults: a qualitative interview study in primary care. Jones, D., Ali, O. M, Honey, S., Surr, C., Scott, S., De Wit, N., & Neal, R. D British Journal of General Practice, May, 2023.

Paper doi abstract bibtex

Background Cancer is predominantly a disease of older adults. To date there has been little research on the experiences of older adults or their views on the diagnostic pathway. Aim To gain an improved understanding of the views and experiences of older adults on all aspects of cancer investigation. Design and setting This was a qualitative study using semi-structured interviews with patients aged ≥70 years. Patients were recruited from primary care in West Yorkshire, UK. Method Data were analysed using a thematic framework analysis. Results The themes identified in participants’ accounts included the patients’ process of decision making, the value of having a diagnosis, the patients’ experience of cancer investigations, and the impact of the COVID-19 pandemic on the diagnostic pathway. Older adults in this study indicated a clear preference for having clarity on the cause of symptoms and the diagnosis, even in the face of unpleasant investigations. Patients suggested they wanted to be involved in the decision process. Conclusion Older adults who present to primary care with symptoms suggestive of cancer may accept diagnostic testing solely for the benefit of knowing the diagnosis. There was a clear patient preference that referrals and investigations for cancer symptoms should not be deferred or delayed based on age or subjective assessments of frailty. Shared decision making and being involved in the decision-making process are important to patients, regardless of age.

@article{jones_patients_2023,
	title = {Patients’ views on the decision to investigate cancer symptoms in older adults: a qualitative interview study in primary care},
	issn = {0960-1643, 1478-5242},
	shorttitle = {Patients’ views on the decision to investigate cancer symptoms in older adults},
	url = {http://bjgp.org/lookup/doi/10.3399/BJGP.2022.0622},
	doi = {10.3399/BJGP.2022.0622},
	abstract = {Background
              Cancer is predominantly a disease of older adults. To date there has been little research on the experiences of older adults or their views on the diagnostic pathway.
            
            
              Aim
              To gain an improved understanding of the views and experiences of older adults on all aspects of cancer investigation.
            
            
              Design and setting
              This was a qualitative study using semi-structured interviews with patients aged ≥70 years. Patients were recruited from primary care in West Yorkshire, UK.
            
            
              Method
              Data were analysed using a thematic framework analysis.
            
            
              Results
              The themes identified in participants’ accounts included the patients’ process of decision making, the value of having a diagnosis, the patients’ experience of cancer investigations, and the impact of the COVID-19 pandemic on the diagnostic pathway. Older adults in this study indicated a clear preference for having clarity on the cause of symptoms and the diagnosis, even in the face of unpleasant investigations. Patients suggested they wanted to be involved in the decision process.
            
            
              Conclusion
              Older adults who present to primary care with symptoms suggestive of cancer may accept diagnostic testing solely for the benefit of knowing the diagnosis. There was a clear patient preference that referrals and investigations for cancer symptoms should not be deferred or delayed based on age or subjective assessments of frailty. Shared decision making and being involved in the decision-making process are important to patients, regardless of age.},
	language = {en},
	urldate = {2023-07-03},
	journal = {British Journal of General Practice},
	author = {Jones, Daniel and Ali, Omer M and Honey, Stephanie and Surr, Claire and Scott, Suzanne and De Wit, Niek and Neal, Richard D},
	month = may,
	year = {2023},
	pages = {BJGP.2022.0622},
}

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Aim To gain an improved understanding of the views and experiences of older adults on all aspects of cancer investigation. Design and setting This was a qualitative study using semi-structured interviews with patients aged ≥70 years. Patients were recruited from primary care in West Yorkshire, UK. Method Data were analysed using a thematic framework analysis. Results The themes identified in participants’ accounts included the patients’ process of decision making, the value of having a diagnosis, the patients’ experience of cancer investigations, and the impact of the COVID-19 pandemic on the diagnostic pathway. Older adults in this study indicated a clear preference for having clarity on the cause of symptoms and the diagnosis, even in the face of unpleasant investigations. Patients suggested they wanted to be involved in the decision process. Conclusion Older adults who present to primary care with symptoms suggestive of cancer may accept diagnostic testing solely for the benefit of knowing the diagnosis. There was a clear patient preference that referrals and investigations for cancer symptoms should not be deferred or delayed based on age or subjective assessments of frailty. 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To date there has been little research on the experiences of older adults or their views on the diagnostic pathway.\n \n \n Aim\n To gain an improved understanding of the views and experiences of older adults on all aspects of cancer investigation.\n \n \n Design and setting\n This was a qualitative study using semi-structured interviews with patients aged ≥70 years. Patients were recruited from primary care in West Yorkshire, UK.\n \n \n Method\n Data were analysed using a thematic framework analysis.\n \n \n Results\n The themes identified in participants’ accounts included the patients’ process of decision making, the value of having a diagnosis, the patients’ experience of cancer investigations, and the impact of the COVID-19 pandemic on the diagnostic pathway. Older adults in this study indicated a clear preference for having clarity on the cause of symptoms and the diagnosis, even in the face of unpleasant investigations. Patients suggested they wanted to be involved in the decision process.\n \n \n Conclusion\n Older adults who present to primary care with symptoms suggestive of cancer may accept diagnostic testing solely for the benefit of knowing the diagnosis. There was a clear patient preference that referrals and investigations for cancer symptoms should not be deferred or delayed based on age or subjective assessments of frailty. Shared decision making and being involved in the decision-making process are important to patients, regardless of age.},\n\tlanguage = {en},\n\turldate = {2023-07-03},\n\tjournal = {British Journal of General Practice},\n\tauthor = {Jones, Daniel and Ali, Omer M and Honey, Stephanie and Surr, Claire and Scott, Suzanne and De Wit, Niek and Neal, Richard D},\n\tmonth = may,\n\tyear = {2023},\n\tpages = {BJGP.2022.0622},\n}\n\n","author_short":["Jones, D.","Ali, O. M","Honey, S.","Surr, C.","Scott, S.","De Wit, N.","Neal, R. 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