Abstract
BackgroundSurvival rates following a diagnosis of cancer vary between countries. The International Cancer Benchmarking Partnership (ICBP), a collaboration between six countries with primary care led health services, was set up in 2009 to investigate the causes of these differences. Module 3 of this collaboration hypothesised that an association exists between the readiness of primary care physicians (PCP) to investigate for cancer – the ‘threshold’ risk level at which they investigate or refer to a specialist for consideration of possible cancer – and survival for that cancer (lung, colorectal and ovarian). We describe the development of an international survey instrument to test this hypothesis.MethodsThe work was led by an academic steering group in England. They agreed that an online survey was the most pragmatic way of identifying differences between the jurisdictions. Research questions were identified through clinical experience and expert knowledge of the relevant literature.A survey comprising a set of direct questions and five clinical scenarios was developed to investigate the hypothesis. The survey content was discussed and refined concurrently and repeatedly with international partners. The survey was validated using an iterative process in England. Following validation the survey was adapted to be relevant to the health systems operating in other jurisdictions and translated into Danish, Norwegian and Swedish, and into Canadian and Australian English.ResultsThis work has produced a survey with face, content and cross cultural validity that will be circulated in all six countries. It could also form a benchmark for similar surveys in countries with similar health care systems.ConclusionsThe vignettes could also be used as educational resources. This study is likely to impact on healthcare policy and practice in participating countries.
Highlights
Survival rates following a diagnosis of cancer vary between countries
It comprises five work streams, one of which (Module 3) is focused on primary care aspects of cancer diagnosis. This aspect relates to the period between the patient’s first presentation to a primary care practitioner (PCP) with a symptom of possible oncological significance up to the time that a referral is made to secondary care for further diagnostic investigation or for treatment, when the diagnosis of cancer is made in primary care
This paper describes the development of a survey to assess the differences in primary care as it relates to cancer diagnosis amongst 11 jurisdictions (England, Northern Ireland, Wales, Denmark, Norway, Sweden, British Columbia, Manitoba, Ontario, New South Wales and Victoria) that make up part of the International Cancer Benchmarking Partnership (ICBP)
Summary
Survival rates following a diagnosis of cancer vary between countries. The International Cancer Benchmarking Partnership (ICBP), a collaboration between six countries with primary care led health services, was set up in 2009 to investigate the causes of these differences. The International Cancer Benchmarking Partnership (ICBP) was established with the aims of producing up-to-date survival estimates for selected cancers (breast, colorectal, lung, ovary), establishing whether these differences have changed over time and to investigate possible causes of survival deficits identified [2]. It comprises five work streams, one of which (Module 3) is focused on primary care aspects of cancer diagnosis. Such factors can be: 1) structural, such as access to investigations, access to specialist advice, 2) organisational, such as degree of gatekeeping [7] and safety netting practices, and 3) knowledge and skills, such as the awareness of cancer symptoms and diagnostic skills among PCP
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