RT Journal Article
SR Electronic
T1 Factors influencing the symptom appraisal and help seeking of older adults with possible cancer: a mixed methods systematic review
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP BJGP.2021.0655
DO 10.3399/BJGP.2021.0655
A1 Daniel Joseph Jones
A1 Erica di Martino
A1 Stephen H. Bradley
A1 Blessing Essang
A1 Scott Hemphill
A1 Judy Wright
A1 Cristina Renzi
A1 Claire Surr
A1 Andrew Paul Clegg
A1 Richard Neal
YR 2022
UL http://bjgp.org/content/early/2022/06/15/BJGP.2021.0655.abstract
AB Background: The burden of cancer falls predominantly on older adults. Prompt presentation to primary care with cancer symptoms could result in an earlier diagnosis. However patient appraisal and help seeking decisions involving cancer symptoms are complex and may be further complicated in older adults. Aim: To explore the effect of older age on patients’ appraisal of symptoms that may indicate cancer and their decision to seek help for these symptoms. Design: Mixed methods systematic review Method: Electronic databases were searched for studies on the appraisal and help seeking of cancer symptoms by adults aged 65 and over. Studies were analysed using thematic synthesis and according to the Synthesis Without Meta-Analysis (SWiM) guidelines Results: Eighty studies were included in the review with a total of 324995 participants. The studies suggested an association between increasing age and a prolonged appraisal interval. Factors such as reduced knowledge of cancer symptoms and differences in symptom interpretation may contribute to this prolonged interval. In contrast, we found an association between increasing age and prompt help-seeking. Themes affecting help seeking included the influence of family and carers, competing priorities, fear, embarrassment, fatalism, co-morbidities, a desire to avoid doctors, a perceived need to not waste doctor’s time and patient self-management of symptoms. Conclusions: This review suggests that increasing age is associated with delayed symptom appraisal. As a result of this review, policy makers, charities and information from GPs should aim to ensure older adults are able to recognise potential symptoms of cancer and can seek help promptly.