GP views on the impact of the COVID-19 pandemic on cancer assessment in primary care: results from the CanImpact study

New evidence on the impact of the COVID-19 pandemic on GP assessment of patients who may have cancer indicates need for urgent action.

The COVID-19 pandemic has dramatically influenced different aspects of patients’ cancer pathways, from diagnosis to treatment, mortality and survival. Implications are also likely early in the diagnostic pathway, from symptom presentation to processes and timescales for referral to specialist services. Recognising limited data on general practitioner (GP) views on the impact of the COVID-19 pandemic of clinical assessment of patients with possible cancer, the CanImpact study interviewed 23 GPs in the East of England in August and September 2020. The study was published today in BJGP Open.

Three themes were identified and included GP views on the impact of:  patient help-seeking behaviour on symptoms at presentation; remote consultations on managing patients with possible cancer symptoms, and the COVID-19 pandemic on triaging and referring patients with possible cancer. While there were positive changes to practice, GPs also raised concerns about the appropriateness of remote consultations for assessing symptoms that may indicate cancer. Some GPs reported delayed cancer diagnoses, and uncertainty about how to manage backlogs of referrals. Diagnostic tests such as the faecal immunochemical test (FIT) were being used more often to rule out colorectal cancer – sometimes before a face-to-face appointment could be arranged.

Prof Fiona Walter, senior author of the study, said: “Interviews indicate that rapid changes brought by the COVID-19 pandemic may have negatively impacted on safe and effective management in primary care. Importantly, there is also some indication that these changes may have potentially led to delays in cancer diagnoses. Building upon our findings and emerging evidence, we have listed several recommendations to inform patient management in primary care.”

This research was co-funded by the Cancer Research UK-funded CanTest Collaborative and the National Institute for Health Research (NIHR) Policy Research Programme (conducted through the Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis).

Archer S, Calanzani N, Honey S, et al. Impact of the COVID-19 pandemic on cancer assessment in primary care: a qualitative study of GP views. BJGP Open 2021; doi: 10.3399/BJGPO.2021.0056