Investigating the role of the general practitioner in cancer prevention: a mixed methods study

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AbstractBackground: Despite evidence of the effectiveness of cancer preventive services and the increasing developmentof guidelines, actual rates of delivery of cancer prevention activities remain low. Due to their frequent front-linecontact with the public, family physicians (GPs) have the potential to play an important role in the primaryprevention of cancer. However, there is a lack of information about their actual role in cancer prevention. The aimof this study was to investigate the actual and potential roles of general practitioners (GP) in the prevention ofcancer.Methods: A sequential exploratory mixed methods approach was used. The sample included all the GeneralPractice (GP) practices in a region in the UK (n=345). Postal questionnaires were administered to GPs (n=1249);following 290 returns (response rate 23%), semi-structured interviews were undertaken with GPs (n=14).Results: The majority of the GP respondents (66.4%, n=184) considered that they routinely provided cancerprevention information. This was specifically focusing on smoking cessation as almost all GPs (96.8%, n=270)enquired about a patient’s smoking status. Overall, 47.2% (n=128) of GP respondents indicated that they felt theydid not have time to perform a cancer prevention role; however, 88.3% (n=242) still felt that they had the‘opportunity’ to do so. Over half the sample (61.3%, n=168) indicated that imposed health priorities and targetsmilitated against providing cancer prevention activities. Almost all the GP respondents (98.9%, n=273) agreed withempowering individuals to take responsibility for their health issues. The GPs identified the need for alternativemodels for cancer prevention beyond current face to face patient care, including other health and non-healthprofessionals. Whilst lack of time was identified as a critical factor, the GPs indicated that significant efforts weremade to encourage patients to take personal responsibility for lifestyle choices.Conclusions: The GPs indicated a need for training around behavioural change and theories of motivation andaction. This has implications for primary care and family physicians worldwide. While doctor–patient consultationsand the physicians’ credibility offer great potential for cancer prevention, time pressures and imposed governmenttargets often mean that their actual cancer prevention role is reduced.Keywords: Cancer, Prevention, General practitioners, Primary health care,
Original languageEnglish
JournalBMC Family Practice
Issue number58
Publication statusPublished (in print/issue) - 2013


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