Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Scottish Cancer Registry, Information Services Division, NHS National Services Scotland, Edinburgh, UK.
BMJ Open. 2017 Dec 21;7(12):e017929. doi: 10.1136/bmjopen-2017-017929.
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.
The approach taken includes systematic searches of published and unpublished literature without any date or language restrictions.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.
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.
CRD42016051692.
随着癌症幸存者寿命的延长，第二原发癌（SPC）的发病率也将上升。对于 SPC 的诊断途径、人们如何评估、解释症状以及寻求第二种不同癌症的帮助以及与 SPC 相关的医疗保健提供者的经验（包括挑战），相对了解甚少。本研究旨在系统地评估和综合 SPC 诊断途径以及相关患者和医疗保健提供者经验的文献。
所采用的方法包括对已发表和未发表的文献进行系统搜索，不限制日期或语言。将搜索 MEDLINE、Embase、CAB 摘要、MEDLINE 正在处理中和非索引引文、PsycINFO、Epub 先行打印、正在处理中和其他非索引引文、Ovid MEDLINE 每日、CINAHL、ASSIA、社会学摘要、Web of Science、PROSPERO 和灰色文献，以确定感兴趣的观察性、系统评价、混合方法和定性研究。至少两名评审员将独立筛选标题、摘要和全文，以符合纳入排除标准。将提取相关结局以及研究和人群特征。综合使用将由治疗途径模型和 Olesen 时间间隔模型指导。
不需要伦理批准。本系统评价将更深入地了解 SPC 复杂且异质的诊断途径，同时确定诊断间隔、诊断途径和患者及医疗保健提供者经验的共同主题。这些发现将有助于提供 SPC 诊断途径的细致画面，从而为政策和一致的实践提供信息。特别是，针对 SPC 的早期诊断方法；包括患者寻求治疗的决定背后的时间和原因、医疗保健提供者面临的挑战，以及未来减少患者就诊时间延迟的干预措施的发展。
PROSPERO 注册号：CRD42016051692。
