Primary care use by men with symptoms of possible prostate cancer: A multi‐method study with an ethnically diverse sample in London
Open Access
- 21 June 2021
- journal article
- research article
- Published by Hindawi Limited in European Journal of Cancer Care
- Vol. 30 (6), e13482
- https://doi.org/10.1111/ecc.13482
Abstract
Objective The objective of this study is to investigate primary care use by men with recent onset of lower urinary tract symptoms (LUTS) to identify differences in presentation and investigation that may explain ethnic inequality in prostate cancer outcomes. Methods This is a multi-method study of men presenting LUTS to primary care. Two hundred seventy-four men completed a self-administered questionnaire, and 23 participated in face-to-face interviews. Regression analyses investigated ethnic differences in (a) the period between symptom onset and first primary care presentation (patient interval) and (b) the interval between first primary care presentation and investigation with prostate-specific antigen (PSA) and digital rectal examination (DRE). Interview data were analysed using thematic analysis. Results Half (144, 53%) reported a solitary first symptom, although multiple first symptoms were also common, particularly in Asian and Black men. There was no difference between ethnicities in patient interval or time from presentation to investigation. However, Asian men were offered less PSA testing (odds ratio 0.39; 95% confidence interval 0.17–0.92; p = 0.03). Qualitative data revealed ethnic differences in general practitioners' offer of DRE and PSA testing and highlighted limitations in doctor–patient communication and safety netting. Conclusion Our study showed only small differences in primary care experiences, insufficient to explain ethnic inequalities in prostate cancer outcomes.Keywords
Funding Information
- Cancer Research UK (C8640/A23385)
This publication has 43 references indexed in Scilit:
- Patient-reported measurement of time to diagnosis in cancer: development of the Cancer Symptom Interval Measure (C-SIM) and randomised controlled trial of method of deliveryBMC Health Services Research, 2014
- The Aarhus statement: improving design and reporting of studies on early cancer diagnosisBritish Journal of Cancer, 2012
- Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry dataThe Lancet, 2011
- Five misconceptions in cancer diagnosisBritish Journal of General Practice, 2009
- Pathways to diagnosis for Black men and White men found to have prostate cancer: the PROCESS cohort studyBritish Journal of Cancer, 2008
- Lower urinary tract symptoms and risk of prostate cancer: The HUNT 2 Cohort, NorwayInternational Journal of Cancer, 2008
- Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2BMJ, 2008
- Lower urinary tract symptoms and related help‐seeking behaviour in South Asian men living in the UKBJU International, 2006
- Using thematic analysis in psychologyQualitative Research in Psychology, 2006
- Androgen receptor protein expression in prostatic tissues in black and caucasian menThe Prostate, 2004