International Journal of Clinical Pharmacy

, Volume 37, Issue 3, pp 465–470 | Cite as

Widening the scope for early cancer detection: identification of alarm symptoms by community pharmacies

  • Jay Badenhorst
  • Adam Todd
  • Laura Lindsey
  • Jonathan Ling
  • Andy Husband
Research Article

Abstract

Background Cancers are one of the leading causes of death in the world and, due to the aging population, incidence rates are set to rise. As such, considerable effort has been placed on initiatives that aid the early detection of cancer, as this may improve patient survival outcome. One such initiative is the development of guidelines that explain how and when patient reported alarm symptoms suggestive of an underlying malignancy should be referred to a specialist. However, despite being conveniently placed to deliver interventions to promote the early detection of cancer, it is not clear what role community pharmacists could have in the development and implementation of these guidelines. Objective To: (1) assess the frequency and mean of patient reported alarm symptoms in a community pharmacy setting; (2) determine the demographics of patients presenting with the alarm symptom; and (3) explore the relationship between deprivation index of the community pharmacy and average frequency of alarm symptoms per pharmacy. Setting Thirty-three community pharmacies in the North of England. Method A prospective study from September 2013 to February 2014. Each community pharmacy team was provided training in relation to alarm symptoms to ensure there was consistency in reporting. Deprivation tertiles for each community pharmacy were calculated using the IMD 2010 deprivation index. The data were analysed using a Kruskal–Wallis test in order to determine whether there were any statistically significant associations between average frequency of alarm symptoms presented per pharmacy and the deprivation tertile. Main outcome measure Frequency of patient reported alarm symptoms.

Keywords

Alarm symptoms Community pharmacy Early cancer detection United Kingdom 

Notes

Acknowledgments

None.

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Conflicts of interest

None.

References

  1. 1.
    Cancer Factsheet. The World Health Organisation. 2014. http://www.who.int/mediacentre/factsheets/fs297/en/. Accessed 16 Oct 2014.
  2. 2.
    Boyle P, Levin B. World Cancer Report 2008. Lyon: The World Health Organisation. 2008. http://www.iarc.fr/en/publications/pdfs-online/wcr/2008/. Accessed 16 Oct 2014.
  3. 3.
    Stewart BW, Kleihues P. World Cancer Report. Lyon: The World Health Organization. 2003. http://www.iarc.fr/en/publications/pdfs-online/wcr/2003/. Accessed 16 Oct 2014.
  4. 4.
    Cancer Research UK. Cancer incidence in the UK in 2011. London: Cancer Research UK. 2014. http://www.cancerresearchuk.org/cancer-info/cancerstats/incidence/uk-cancer-incidence-statistics. Accessed 16 Oct 2014.
  5. 5.
    Richards MA. The size of the prize for earlier diagnosis of cancer in England. Br J Cancer. 2009;101(2):S125–9.CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    O’Dowd EL, McKeever TM, Baldwin DR, Anwar S, Powell HA, Gibson JE, Iyen-Omofoman B, Hubbard RB. What characteristics of primary care and patients are associated with early death in patients with lung cancer in the UK? Thorax. 2014;. doi:10.1136/thoraxjnl-2014-205692.PubMedCentralPubMedGoogle Scholar
  7. 7.
    National Institute for Health and Clinical Excellence. Referral guidelines for suspected cancer. 2005. http://www.nice.org.uk/nicemedia/pdf/CG027quickrefguide.pdf. Accessed 28 June 2014.
  8. 8.
    Shapley M, Mansell G, Jordan JL, Jordan KP. Positive predictive values of >5 % in primary care for cancer: systematic review. Br J Gen Pract. 2010;60:e366–77.CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Jones R, Latinovic R, Charlton J, Gulliford MC. Alarm symptoms in early diagnosis of cancer in primary care: cohort study using general practice research database. Br Med J. 2007;334:1040.CrossRefGoogle Scholar
  10. 10.
    Rachet B, Ellis L, Maringe C, Chu T, Nur U, Quaresma M, et al. Socioeconomic inequalities in cancer survival in England after the NHS cancer plan. Br J Cancer. 2010;103:446–53.CrossRefPubMedCentralPubMedGoogle Scholar
  11. 11.
    Information Services Division Scotland (ISD). Cancer statistics: cancer of the oesophagus. 2014. http://www.isdscotland.org/Health-Topics/Cancer/Cancer-Statistics/Oesophagal/. Accessed 28 June 2014.
  12. 12.
    Hart JT. The inverse care law. The Lancet. 1971;297:405–12.CrossRefGoogle Scholar
  13. 13.
    Department of Health. 2014. Be clear on cancer campaign. http://campaigns.dh.gov.uk/category/beclearoncancer/. Accessed 28 June 2014.
  14. 14.
    Kennington E, Allen B, Wright H, Dear M, Patel N. Early detection of lung cancer symptoms—a role for community for pharmacy. Int J Pharm Pract. 2012;20(1):17–8.Google Scholar
  15. 15.
    Kennington E, Carter S, Dear M, Allen B, Patel N. Bowel cancer symptom presentation in community pharmacy—an opportunity for early detection? Int J Pharm Pract. 2012;20(2):19–20.Google Scholar
  16. 16.
    NHS Scotland. Better health, better care: action plan. Edinburgh: The Scottish Government. 2008. http://www.scotland.gov.uk/Resource/Doc/210642/0055693.pdf. Accessed 28 June 2014.
  17. 17.
    Benrimoj SI, Frommer MS. Community pharmacy in Australia. Aust Health Rev. 2004;28:238–46.CrossRefPubMedGoogle Scholar
  18. 18.
    Todd A, Copeland A, Husband A, Kasim A, Bambra C. The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England. BMJ Open. 2014;4(8):e005764.CrossRefPubMedCentralPubMedGoogle Scholar
  19. 19.
    Boardman H, Lewis M, Croft P, Trinder P, Rajaratnam G. Use of community pharmacies: a population-based survey. J Public Health (Oxf). 2005;27(3):254–62.CrossRefGoogle Scholar
  20. 20.
    Community Pharmacy Contractual Framework. http://psnc.org.uk/contract-it/the-pharmacy-contract/. Accessed 16 Oct 2014.
  21. 21.
    Anon NPA. Launches training with a W-WHAM. Pharm J. 1989;243:40.Google Scholar
  22. 22.
    Department for Communities and Local Government. The english indices of deprivation. 2010. London: Crown Copyright; 2011. https://www.gov.uk/government/publications/english-indices-of-deprivation-2010. Accessed 28 June 2014.
  23. 23.
  24. 24.
    Office for National Statistics. Ethnicity and national identity in England and Wales 2011. http://www.ons.gov.uk/ons/dcp171776_290558.pdf. Accessed 16 Oct 2014.
  25. 25.
    Potter MB, Gildengorin G, Wang Y, Wu M, Kroon L. Comparative effectiveness of two pharmacy-based colorectal cancer screening interventions during an annual influenza vaccination campaign. J Am Pharm Assoc. 2010;50(2):181–7.CrossRefGoogle Scholar
  26. 26.
    Mayer JA, Eckhardt L, Stepanski BM, Sallis JF, Elder JP, Slymen DJ, et al. Promoting skin cancer prevention counseling by pharmacists. Am J Public Health. 1998;88(7):1096–9.CrossRefPubMedCentralPubMedGoogle Scholar
  27. 27.
    Punwani R, Draper A, Loke T, Keddie Z, O’Brien M. Community Pharmacy Referrals Project (CoPhaR): increasing awareness and early diagnosis of respiratory disease via a direct pathway to secondary care. Lung Cancer. 2014;83(1):S31–2.CrossRefGoogle Scholar
  28. 28.
    National Cancer Intelligence Network (NCIN). Public Health England. Routes to diagnosis: exploring emergency presentations. 2014. http://www.ncin.org.uk/publications/data_briefings/routes_to_diagnosis_exploring_emergency_presentations. Accessed 16 Oct 2014.
  29. 29.
    Robb K, Stubbings S, Ramirez A, Macleod U, Austoker J, Waller J, et al. Public awareness of cancer in Britain: a population-based survey of adults. Br J Cancer. 2009;101:S18–23.CrossRefPubMedCentralPubMedGoogle Scholar
  30. 30.
    Beckles MA, Spiro SG, Colice GL, Rudd RM. Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes. Chest. 2003;123:97S–104S.CrossRefPubMedGoogle Scholar
  31. 31.
    Abdel-Rahman M, Stockton D, Rachet B, Hakulinen T, Coleman MP. What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable? Br J Cancer. 2009;101:S115–24.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Jay Badenhorst
    • 1
  • Adam Todd
    • 2
    • 4
  • Laura Lindsey
    • 2
  • Jonathan Ling
    • 3
  • Andy Husband
    • 2
  1. 1.Whitworth Chemist Ltd.ScunthorpeUK
  2. 2.Division of Pharmacy, School of Medicine, Pharmacy and HealthDurham UniversityStockton-on-TeesUK
  3. 3.Department of Pharmacy, Health and WellbeingUniversity of SunderlandSunderlandUK
  4. 4.Centre for Health and Inequalities Research (CHIR)Durham UniversityDurhamUK

Personalised recommendations