British Journal of General Practice最新文献

{"title":"Factors affecting prostate cancer detection through asymptomatic prostate-specific antigen testing in primary care in England: evidence from the 2018 National Cancer Diagnosis Audit.","authors":"Samuel Wd Merriel, Nurunnahar Akter, Nadine Zakkak, Ruth Swann, Sean McPhail, Greg Rubin, Georgios Lyratzopoulos, Gary Abel","doi":"10.3399/BJGP.2024.0376","DOIUrl":"10.3399/BJGP.2024.0376","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific antigen (PSA) is used in primary care for prostate cancer detection, either for symptomatic assessment or asymptomatic testing following an informed decision.</p><p><strong>Aim: </strong>To estimate the proportion of patients with prostate cancer who were diagnosed following asymptomatic PSA testing, and the patient and practice factors influencing this route.</p><p><strong>Design and setting: </strong>The 2018 English National Cancer Diagnosis Audit (NCDA) data were analysed, with linkage to the National Cancer Registration and Analysis Service, practice-level Quality and Outcomes Framework (QOF), and GP Patient Survey (GPPS) data. All 2018 NCDA patients with a diagnosis of prostate cancer were included (<i>n</i> = 9837).</p><p><strong>Method: </strong>Patients with recorded biomarker testing and no recorded symptoms before diagnosis were classified as having asymptomatic PSA-detected prostate cancer. Patient (age, ethnicity, deprivation, and comorbidities) and practice (geographical location, area deprivation, list size, urgent suspected cancer referral rate, QOF outcomes, and GPPS results) factors were analysed for association with asymptomatic PSA testing using mixed-effects logistic regression models.</p><p><strong>Results: </strong>In total, 1884 out of 9837 (19.2%) patients with prostate cancer were detected following asymptomatic PSA testing, 982 (52.1%) of whom were aged 50-69 years. Younger age, non-White ethnicity, lower deprivation, and lower comorbidity count were associated with an increased likelihood of diagnosis following asymptomatic PSA testing. There was a 13-fold variation between practices in the odds of detecting prostate cancer through asymptomatic PSA testing, without clear explanatory practice-level factors.</p><p><strong>Conclusion: </strong>One in five patients with prostate cancer in England are diagnosed after asymptomatic PSA testing in primary care, with large variation in asymptomatic PSA detection between practices.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e300-e305"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom appraisal and help- seeking before a cancer diagnosis during pregnancy: a qualitative study.","authors":"Afrodita Marcu, Emma Ream, Karen Poole, Jo Armes, Faith Gibson, Lisa Whittaker, Jenny Harris","doi":"10.3399/BJGP.2024.0208","DOIUrl":"10.3399/BJGP.2024.0208","url":null,"abstract":"<p><strong>Background: </strong>The estimated incidence of a cancer diagnosis during or shortly after pregnancy is 1 in 1000 pregnancies in England. Pregnancy can have an impact on symptom appraisal and help-seeking for symptoms subsequently diagnosed as cancer. Little is known about the pathway to cancer diagnosis in pregnancy or delays that women can encounter.</p><p><strong>Aim: </strong>To explore symptom appraisal, help-seeking decisions, and experience of receiving a cancer diagnosis during pregnancy.</p><p><strong>Design and setting: </strong>Semi-structured interviews were conducted with women diagnosed with cancer during or shortly after pregnancy in the previous 4 years in the UK, recruited between January and May 2022 via the charity Mummy's Star.</p><p><strong>Method: </strong>This study used reflexive thematic analysis of 20 interviews. Analysis was largely inductive and the themes generated were mapped onto the intervals of the Model of Pathways to Treatment.</p><p><strong>Results: </strong>Symptoms were often interpreted through the lens of pregnancy by both participants and most of the healthcare professionals from whom they sought help. Participants who found breast lumps were likely to suspect cancer and be referred promptly for tests in secondary care. Although most participants sought timely help for their symptoms, some subsequently encountered health system delays, partly owing to both the vague nature of their symptoms and the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>Health services need to better support women presenting with possible cancer symptoms during pregnancy to ensure timely diagnosis. Recommendations include prioritising symptoms over attributing them solely to pregnancy, ensuring timely referrals to rule out serious conditions, and emphasising clear communication alongside robust safety-netting practices. A full assessment is essential before dismissing symptoms as pregnancy related.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e341-e348"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient outcomes from a physical activity programme for cancer survivors in general practice: an intervention implementation study.","authors":"Famke Huizinga, Nico-Derk L Westerink, Annemiek Me Walenkamp, Annette J Berendsen, Mathieu Hg de Greef, Michiel R de Boer, Geertruida H de Bock, Marjolein Y Berger, Daan Brandenbarg","doi":"10.3399/BJGP.2024.0558","DOIUrl":"10.3399/BJGP.2024.0558","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) benefits cancer survivors' health, yet no PA programmes are incorporated in Dutch general practice.</p><p><strong>Aim: </strong>To evaluate cancer survivors' outcomes following a PA programme in general practice.</p><p><strong>Design and setting: </strong>A single-arm PA intervention implementation study among cancer survivors in 15 Dutch general practices.</p><p><strong>Method: </strong>Patients aged ≥18 years who completed primary cancer treatment ≥6 months prior were eligible. The 9-month intervention comprised counselling sessions with a primary care practitioner (PCP) aimed at increasing daily PA. Reach, Effectiveness, and Implementation of the RE-AIM framework were evaluated among participants. Primary health outcomes included self-reported symptoms of fatigue, depression, and anxiety; secondary outcomes included step count, caloric expenditure, weight, physical function, self-reported quality of life, and PA. Outcomes were assessed at time (T)₀-T₃ (0, 3, 6, and 9 months) or at PCPs' sessions S1-S6 (0, 3, 6 weeks, and 3, 6, 9 months). Non-participants completed a single baseline questionnaire. The study used (non-)parametric independent tests and linear mixed models for analyses.</p><p><strong>Results: </strong>Of 564 invited patients, 149 (26%) participated. Participants had less formal education, higher unemployment, less PA, and more fatigue and psychological symptoms than non-participants. All primary and most secondary health outcomes improved over time, with clinically relevant changes in step count and physical function. In total, 11% (<i>n</i> = 16/149) dropped out before and 26% (<i>n</i> = 35/133) during the programme. Counselling session adherence and PA goal achievement were 98% (<i>n</i> = 647/661) and 73% (<i>n</i> = 81/111), respectively.</p><p><strong>Conclusion: </strong>The programme reached long-term cancer survivors with poorer health status, and showed positive health changes particularly on PA and physical function. Such PA programmes may benefit the health of a rising number of cancer survivors visiting primary care.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e366-e374"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'My patients are \"gunning for a fight\" that I don't want': reflecting on feeling dismissed and conflict- expectant consultations.","authors":"Abigail McNiven, Amy Dobson, Katie Read, Sharon Dixon","doi":"10.3399/bjgp25X741561","DOIUrl":"https://doi.org/10.3399/bjgp25X741561","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"234-236"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Books: <i>The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far</i>: The curious characterisation of long COVID as a psychosomatic condition.","authors":"Elke Hausmann","doi":"10.3399/bjgp25X741525","DOIUrl":"https://doi.org/10.3399/bjgp25X741525","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"228-229"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating paediatric otorrhoea - response.","authors":"Elliot Heward","doi":"10.3399/bjgp25X741417","DOIUrl":"https://doi.org/10.3399/bjgp25X741417","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"205"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating paediatric otorrhoea.","authors":"Arnold Zermansky","doi":"10.3399/bjgp25X741405","DOIUrl":"https://doi.org/10.3399/bjgp25X741405","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"204"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to general practice.","authors":"Nada Khan","doi":"10.3399/bjgp25X741465","DOIUrl":"https://doi.org/10.3399/bjgp25X741465","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"220-221"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New directions in policy in NHS GP contracts.","authors":"Denis Pereira Gray, Kate Sidaway-Lee, Philip Evans, Nada Khan, Molly Dineen, Alexander Harding","doi":"10.3399/bjgp25X741381","DOIUrl":"https://doi.org/10.3399/bjgp25X741381","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"203-204"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Riding the tides of change.","authors":"Sam Merriel","doi":"10.3399/bjgp25X741333","DOIUrl":"https://doi.org/10.3399/bjgp25X741333","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"195"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}