Does quality of life feedback promote seeking help for undiagnosed cancer?

Suzanne M Skevington,Hannah Long,Nicola Gartland

doi:10.1007/s11136-020-02431-7

Suzanne M Skevington, Hannah Long + Show 1 more

Open Access

https://doi.org/10.1007/s11136-020-02431-7

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Abstract

PurposeDiagnosing cancer early is an imperative, as help-seeking delays affect survival. Quality of life (QoL) deteriorates after diagnosis, but decline may start when cancer is suspected at the earliest stage of the pathway to treatment. This study examined whether offering guided feedback about personal QoL to adults with potential cancer symptoms, living in deprived communities, changes QoL and promotes help-seeking in primary care.MethodsVisitors to a CRUK mobile cancer roadshow were recruited in 43 sites. A prospective longitudinal (2 × 2) repeated-measures design was applied. Where they presented a potential cancer symptom, and were ‘signposted’ to a GP, they were allocated to a symptom condition, or a lifestyle condition, if seeking cancer risk advice. Randomisation was to an Intervention group, who received feedback about personal QoL results (WHOQOL-BREF and WHOQOL importance measures), or a Control group who assessed QoL without feedback. Depression was screened.ResultsOf 107 participants, the mean age was 53; 50% were women, 57% were without tertiary education, 66% were unemployed and 45% were currently ill. Over 10 weeks, 54% of all those with symptoms sought help from a medical source and 42% specifically from a GP. Thirty-one completed all three assessments. With symptoms present, psychological, social and environmental QoL were poor, becoming poorer over time. When the symptoms group received feedback, psychological QoL increased, but GP visits were unaffected. However, feedback increased help-seeking from informal social contacts. Lifestyle groups reported consistently good psychological and social QoL.ConclusionThis early cancer research offers practical and theoretical implications for QoL interventions in deprived communities.

Highlights

Diagnosis improves cancer prognosis [1, 2] and is an intervention priority [3, 4]
As cancer is commonly diagnosed in primary care [5], the timing of the first consultation is crucial to reducing delays in treatment [2]
We examine whether quality of life (QoL) deteriorates at the earliest stage of the pathway, when bodily changes raise cancer awareness before consulting primary care

Summary

Introduction

Diagnosis improves cancer prognosis [1, 2] and is an intervention priority [3, 4]. Recognition that symptoms signal cancer could damage quality of life (QoL), and may influence the timing of consulting a General Practitioner (GP). We examine whether QoL deteriorates at the earliest stage of the pathway, when bodily changes raise cancer awareness before consulting primary care. Interventions feeding-back personal QoL results to patients and professionals can improve clinical communications, promote shared decision-making and guide selfmanagement of health. Community adults report modest improvements to psychological QoL after personal feedback about QoL and its importance [20,21,22]. Whether poor QoL at the time of increasing cancer awareness promotes primary care attendance. Feedback was expected to slow, arrest or possibly improve deteriorating QoL, by actively promoting self-management of health. This research has implications for cancer survival, public health and community care in socio-economically deprived settings.

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