ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2013
Understanding diagnosis of lung cancer in primary care: qualitative synthesis of significant event audit reports.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Factors affecting the decision to investigate older adults with potential cancer symptoms: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Pooled it
- Patient involvement in diagnosing cancer in primary care: a systematic review of current interventions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
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- A geographical cluster randomised stepped wedge study of continuing medical education and cancer diagnosis in general practice.Implementation science : IS · 2014Trial
- Comorbidities, Socioeconomic Status, and Colorectal Cancer Diagnostic Route.JAMA network open · 2025Article
- Mapping intellectual structure and research hotspots of cancer studies in primary health care: A machine-learning-based analysis.Medicine · 2025Article
- The effect of comorbidities on diagnostic interval for lung cancer in England: a cohort study using electronic health record data.British journal of cancer · 2024Article
- Learning from new colorectal cancers: a qualitative synthesis of significant event reports.BJGP open · 2024Article
- The Role of Smoking Status in Making Risk-Informed Diagnostic Decisions in the Lung Cancer Pathway: A Qualitative Study of Health Care Professionals and Patients.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- What are the similarities and differences in lung cancer symptom appraisal and help-seeking according to smoking status? A qualitative study with lung cancer patients.Psycho-oncology · 2022Article
- Factors influencing symptom appraisal and help-seeking of older adults with possible cancer: a mixed-methods systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Time from presentation to pre-diagnostic chest X-ray in patients with symptomatic lung cancer: a cohort study using electronic patient records from English primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Estimating lung cancer risk from chest X-ray and symptoms: a prospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Lung Cancer Pre-Diagnostic Pathways from First Presentation to Specialist Referral.Current oncology (Toronto, Ont.) · 2021Article
- [Improved patient safety through a clinical decision support system in laboratory medicine].Der Internist · 2020Review
- Development of a tool for coding safety-netting behaviours in primary care: a mixed-methods study using existing UK consultation recordings.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Comorbid chronic diseases and cancer diagnosis: disease-specific effects and underlying mechanisms.Nature reviews. Clinical oncology · 2019Review
- Safety netting in routine primary care consultations: an observational study using video-recorded UK consultations.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Observational
- Early symptoms and sensations as predictors of lung cancer: a machine learning multivariate model.Scientific reports · 2019Article
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3 authors.
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Abstract
backgroundMost lung cancers present symptomatically, but the pathway to diagnosis in primary care can be complex and is poorly understood. Significant event audit (SEA) is a quality improvement technique widely used in UK general practice.
aimTo gain insights into the diagnostic process for lung cancer, drawn from analysis of SEA documents. DESIGN AND
settingQualitative analysis of SEAs from 92 general practices in the North of England Cancer Network.
methodParticipating practices were provided with a standardised electronic template and asked to undertake a significant event audit related to the most recent diagnosis of lung cancer in the practice, even if that patient had since died. Reported accounts for 132 diagnoses were analysed using a modified framework approach.
resultsMost SEAs demonstrated timely recognition and referral. Where this had taken longer, there were often reasonable explanations, including: chest X-rays reported as normal or with benign findings; patient-mediated factors, such as delay in re-presenting or declining earlier referral; and presentation complicated by comorbidity. Some opportunities for earlier referral were also found. Lessons drawn from these events included limitations of chest X-ray as a diagnostic tool, the need for vigilance in patients with existing morbidity, and the importance of 'safety-netting'.
conclusionQualitative synthesis of SEAs offered considerable value in understanding circumstances surrounding the diagnostic process for lung cancer in primary care. The most common presentation was with cough or other symptoms indicative of infection, and it is by understanding more about these patients in particular that most can be gained.
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