What factors influence the decision to investigate cancer symptoms in older adults: a qualitative study

Project summary

People of a similar age can have very different levels of health, independence and outlooks on life. This is especially true for older people such as those over 80 years of age who could have poor health and be dependent on others for care. If a frail, older patient experiences symptoms which could be caused by cancer, national guidelines advise that patients should be tested for cancer, regardless of age or health status. This may not always be in the patient’s best interests.

When older patients are diagnosed with cancer there may be limited treatment options – most often due to poor health. Given the option, some older adults may opt to not investigate possible cancer symptoms, allowing GPs to treat their symptoms based on a ‘probable diagnosis’. However, some patients may want to know what is wrong with them. Having a confirmed diagnosis could help patients, and improve their quality of life through better access to cancer services. No research has considered the views of older patients on the desirability of being tested.

We aim to gain an improved understanding of the views and experiences of older people on:

1. the joint decision whether or not to test their symptoms which could be due to cancer;
2. the factors which may affect a patients decision;
3. the value to patients of knowing the ‘probable’ diagnosis.

Older patients who have recently experienced cancer symptoms or been referred to hospital for possible cancer will be identified from their GP records.  Video or telephone interviews will discuss the factors behind their decision to investigate (or not) cancer symptoms.

This study will help researchers better understand how patients decide to investigate cancer symptoms, how important having a diagnosis is, and what influences these decisions. This in turn will support GPs and patients in managing these difficult decisions on when and how to investigate cancer symptoms and when to keep the patient comfortable. This early study will also inform future research to improve the delivery of care of older adults with possible cancer.