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Public health
Protocol
Pathways to diagnosis of a second primary cancer: protocol for a mixed-methods systematic review
  1. Lovney Kanguru1,
  2. Annemieke Bikker1,
  3. Debbie Cavers1,
  4. Karen Barnett1,
  5. David H Brewster1,2,
  6. David Weller1,
  7. Christine Campbell1
  1. 1 Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
  2. 2 Scottish Cancer Registry, Information Services Division, NHS National Services Scotland, Edinburgh, UK
  1. Correspondence to Dr Lovney Kanguru; Lovney.Kanguru{at}ed.ac.uk

Abstract

Introduction As cancer survivors continue to live longer, the incidence of second primary cancers (SPCs) will also rise. Relatively little is understood about the diagnostic pathway for SPCs, how people appraise, interpret symptoms and seek help for a second different cancer and the experiences (including challenges) of healthcare providers relating to SPCs. This study aims to systematically appraise and synthesise the literature on the pathways to diagnosis of an SPC and the associated patient and healthcare provider experiences.

Methods The approach taken includes systematic searches of published and unpublished literature without any date or language restrictions. MEDLINE, Embase, CAB Abstracts, MEDLINE In-Process and non-indexed citations, PsycINFO, Epub Ahead of Print, In-Process and other non-indexed citations, Ovid MEDLINE Daily, CINAHL, ASSIA, Sociological Abstracts, Web of Science, PROSPERO and grey literature will be searched to identify observational, systematic reviews, mixed methods and qualitative studies of interest. Titles, abstracts and full texts will be screened against the inclusion–exclusion criteria by at least two reviewers independently. Relevant outcomes of interest and study and population characteristics will be extracted. Synthesis will be used guided by the Pathways to Treatment model and the Olesen model of time intervals.

Ethics and dissemination Ethical approval is not required. This systematic review will provide a deeper understanding of the complex and heterogeneous diagnostic pathways of SPCs, while identifying common themes across the diagnostic interval, routes to diagnosis and patient and healthcare provider experiences. These findings will help provide a nuanced picture of the diagnostic pathway for SPCs that may inform policy and consistent practice. In particular, approaches to early diagnosis for an SPC; including the timing and reasons behind the decision by the patient to seek care,the challenges faced by healthcare providers, and in the development of future interventions to reduce the delay in patient time-to-presentation.

PROSPERO registration number CRD42016051692.

  • Second Primary Cancer
  • Diagnostic Pathway
  • Routes To Diagnosis
  • Diagnostic Interval
  • Patient And Health-care Provider Experiences
  • Heath-care Provider Challenges

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjopen-2017-017929

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    Footnotes

    • Contributors The systematic review was conceived by DC, KB, CC and DW. LK and AB designed the systematic review protocol with inputs from DC, CC, DW, DHB and KB. LK drafted the manuscript with subsequent input from other authors. CC is the guarantor and the principal investigator of this review.

    • Funding The systematic review is part of a larger study looking at understanding pathways to diagnosis, patient and providers’ experiences and survival outcomes for second primary cancers, funded by the Cancer Research UK (reference code C12357/A21326).

    • Competing interests None declared.

    • Ethics approval The University of Edinburgh Centre for Population Health Sciences Ethical Review Committee reviewed and approved this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.