Blane David N, MacDonald Sara, O'Donnell Catherine A
General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
BJGP Open. 2022 Mar 22;6(1). doi: 10.3399/BJGPO.2021.0108. Print 2022 Mar.
It is estimated that nearly 600 000 cancer cases in the UK could have been avoided in the past 5 years if people had healthier lifestyles, with the principle modifiable risk factors being smoking, obesity, alcohol consumption, and inactivity. There is growing interest in the use of cancer risk information in general practice to encourage lifestyle modification.
To explore the views and experiences of patients and practitioners in relation to cancer prevention and cancer risk discussions in general practice.
DESIGN & SETTING: Qualitative study among patients and practitioners in general practices in Glasgow, UK.
Semi-structured interviews were conducted with nine practitioners (five GPs and four practice nurses, recruited purposively from practices based on list size and deprivation status), and 13 patients (aged 30-60 years, with two or more specified comorbidities).
Currently, cancer risk discussions focus on smoking and cancer, with links between alcohol and/or obesity and cancer rarely made. There was support for the use of the personalised cancer risk tool as an additional resource in primary care. Practitioners felt practice nurses were best placed to use it. Use in planned appointments (for example, chronic disease reviews) was preferred over opportunistic use. Concerns were expressed, however, about generating anxiety, time constraints, and widening inequalities.
Health behaviour change is complex and the provision of information alone is unlikely to have significant effects. Personalised risk tools may have a role, but important concerns about their use remain, particularly in areas of socioeconomic disadvantage.
据估计，在过去5年中，如果人们拥有更健康的生活方式，英国近60万例癌症病例本可避免，主要的可改变风险因素包括吸烟、肥胖、饮酒和缺乏运动。在全科医疗中利用癌症风险信息来鼓励改变生活方式的兴趣日益浓厚。
探讨患者和从业者对于全科医疗中癌症预防及癌症风险讨论的观点和经历。
对英国格拉斯哥全科医疗中的患者和从业者进行定性研究。
对9名从业者（5名全科医生和4名执业护士，根据名单规模和贫困状况从医疗机构中有目的地招募）和13名患者（年龄在30至60岁之间，患有两种或更多特定合并症）进行半结构化访谈。
目前，癌症风险讨论主要集中在吸烟与癌症上，很少提及酒精和/或肥胖与癌症之间的联系。大家支持将个性化癌症风险工具作为初级保健中的一种额外资源。从业者认为执业护士最适合使用该工具。相较于机会性使用，更倾向于在预约安排（如慢性病复查）中使用。然而，有人担心这会引发焦虑、造成时间限制并加剧不平等。
健康行为改变很复杂，仅提供信息不太可能产生显著效果。个性化风险工具可能会发挥作用，但对其使用仍存在重要担忧，尤其是在社会经济劣势地区。
