Abstract
Background
The incidence of early-onset colorectal cancer (EOCRC) in adults aged
Aim
To explore awareness of the increasing incidence of EOCRC, and to understand the potential barriers or facilitators faced by GPs when referring younger adults to secondary care with features indicative of EOCRC.
Design & setting
Qualitative methodology, via virtual semi-structured interviews with 17 GPs in Northern Ireland.
Method
Reflective thematic analysis was conducted with reference to Braun and Clarke’s framework.
Results
Three main themes were identified among participating GPs: awareness, diagnostic, and referral challenges. Awareness challenges focused on perceptions of EOCRC being solely associated with hereditary cancer syndromes, and colorectal cancer being a condition of older adults. Key diagnostic challenges centred around the commonality of lower gastrointestinal complaints and overlap in EOCRC symptoms with benign conditions. Restrictions in age-based referral guidance and a GP ‘guilt complex’ surrounding over-referral to secondary care summarised the referral challenges. Young females were perceived as being particularly disadvantaged with regard to delays in diagnosis.
Conclusion
This novel research outlines potential reasons for the diagnostic delays seen in patients with EOCRC from a GP perspective, and highlights many of the complicating factors that contribute to the diagnostic process.
The incidence of early-onset colorectal cancer (EOCRC) in adults aged
Aim
To explore awareness of the increasing incidence of EOCRC, and to understand the potential barriers or facilitators faced by GPs when referring younger adults to secondary care with features indicative of EOCRC.
Design & setting
Qualitative methodology, via virtual semi-structured interviews with 17 GPs in Northern Ireland.
Method
Reflective thematic analysis was conducted with reference to Braun and Clarke’s framework.
Results
Three main themes were identified among participating GPs: awareness, diagnostic, and referral challenges. Awareness challenges focused on perceptions of EOCRC being solely associated with hereditary cancer syndromes, and colorectal cancer being a condition of older adults. Key diagnostic challenges centred around the commonality of lower gastrointestinal complaints and overlap in EOCRC symptoms with benign conditions. Restrictions in age-based referral guidance and a GP ‘guilt complex’ surrounding over-referral to secondary care summarised the referral challenges. Young females were perceived as being particularly disadvantaged with regard to delays in diagnosis.
Conclusion
This novel research outlines potential reasons for the diagnostic delays seen in patients with EOCRC from a GP perspective, and highlights many of the complicating factors that contribute to the diagnostic process.
| Original language | English |
|---|---|
| Number of pages | 10 |
| Journal | BJGP Open |
| Early online date | 18 Oct 2023 |
| DOIs | |
| Publication status | Early online date - 18 Oct 2023 |
Keywords
- qualitative research
- delayed diagnosis
- general practice
- qFIT
- Colorectal neoplasms
- primary health care
Access to Document
- Referral challenges for early-onset colorectal cancer: a qualitative study in UK primary care
Copyright 2023 The Authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.