Exploring the feasibility of gathering economic data for ThinkCancer!: supporting the early diagnosis of cancer in primary care

Conference:

SAPC ASM 2020 - cancelled due to pandemic

Talk Code:

C.2

Presenter:

Bethany F Anthony

Twitter:

@BethanyFAnthony

Co-authors:

Bethany F Anthony1, Professor Richard Neal2, Professor Clare Wilkinson3, Professor Rhiannon T Edwards1, on behalf of the WICKED team

Author institutions:

1Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, 2Leeds Institute of Health Sciences, Leeds University, 3North Wales Centre for Primary Care Research, Bangor University,

Problem

Invaluable progress has been made in improving cancer outcomes in the UK, with approximately 1 in 2 patients living with cancer in England and Wales now surviving for 10 years or more. Despite this progress, cancer survival in the UK continues to be lower compared to other Westernised countries including Australia, Canada and a number of other European countries. Welsh Government outline a number of challenges with respect to earlier cancer diagnosis including a lack of awareness of ‘red flag’ symptoms and difficulties among GPs and other healthcare professionals in identifying cancers that present with vague or non-specific symptoms. For some cancers, earlier diagnosis is associated with greater survival and better patient quality of life and experience. The aim of this current study was to conduct a feasibility economic analysis of the ThinkCancer! intervention to improve earlier cancer diagnosis in primary care.

Approach

The ThinkCancer! intervention is a complex behaviour change intervention, which aims to change the behaviours of primary care practice teams, when thinking of and acting on clinical symptoms that could be cancer. From an NHS perspective, we will conduct a feasibility economic analysis of the ThinkCancer! intervention. We will use micro-costing to determine whether it is feasible to gather sufficient economic data to cost the ThinkCancer! intervention. Researchers delivering the intervention will complete cost diaries, which will include staff costs, travel and subsistence costs for delivering the workshops throughout Wales, material costs and overheads. In order to understand the current evidence base on the topic of earlier cancer diagnosis with economic elements, we undertook a rapid scoping review of the literature.

Findings

Scoping searches identified eight published papers. Most of the studies identified (n=5) were costing studies and did not explore both costs and outcome/effects. Three of the studies were screening studies that seek to identify unrecognised cancer, which differ from studies exploring earlier cancer diagnosis that seeks to identify cancer in patients who present with symptoms of the disease. Studies (n=5) were predominately conducted outside of the UK, making comparisons to the NHS difficult. Searches did not identify any published feasibility economic analyses of interventions to expedite earlier cancer diagnosis in primary care.

Consequences

Results of this feasibility study will be used to inform a future definitive economic evaluation alongside a pragmatic randomised controlled trial (RCT). Primary care interventions to expedite the diagnosis of symptomatic cancer have the potential to reduce large costs to the NHS and improve patient and carer outcomes; as later stage cancer treatments are often longer, more aggressive to patients, with larger associated healthcare costs, compared to earlier stage treatment.

Submitted by:

Bethany Anthony

Funding acknowledgement:

Cancer Research Wales