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Facilitators of and obstacles to consultation in patients with advanced basal cell carcinoma: a French pilot study

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Abstract

Basal cell carcinoma is the most common skin cancer for which surgery is usually the unique and definitive treatment. Advanced basal cell carcinoma is not eligible to surgery when underlying structures are destroyed. Delayed consultation is the principal cause of advanced basal cell carcinoma. It is questionable why some patients seek care only when the tumour is advanced. The objective of this study was to identify the psychosocial factors involved in delayed consultation. We used a qualitative approach, conducting semi-structured interviews with advanced basal cell carcinoma patients and the healthcare staff of a dermatology unit to explore why some patients consult only when basal cell carcinoma is advanced. We then put our findings into perspective and created a logical model for change. We interviewed 14 patients and 12 healthcare staff. The first lesion was associated with banalization. Then, denial and fear of diagnosis or treatment were post common. Finally, the advanced basal cell carcinoma’s symptoms, along with social pressure, created the intention to seek medical help and improved disease awareness. We developed a logical model that summarizes these findings. In this pilot study, we modelled factors that delayed consultation. This will aid future research and targeted interventions reducing delay, in particular by improving knowledge and by using social pressure as facilitators. Trial registration: NCT04124796.

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Acknowledgments

We thank Christine Alfaro Coordinator Research Assistant and the medical doctors who participated in the inclusion of patients: Prof. Anne Pham-Ledard and Drs Emilie Gerard, Léa Dousset, Sorilla Prey, and Caroline Dutriaux. We thank all the patients and healthcare staff who participated in this study. Editing: We thank Textcheck and Richard Turner for professional editing of the English (certificate: http://www.textcheck.com/certificate/BK9mHA).

Funding

This work received research funding from French Society of Dermatology and the French Cancer League. These funding organizations had no role in design and conduction of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Author notes

  1. Bruno Quintard and Marie Beylot-Barry contributed equally as last senior author.

Authors and Affiliations

  1. Department of Dermatology, University Hospital of Bordeaux, 1, rue Jean Burguet, 33000, Bordeaux, France

    Constance Garrouteigt, Adeline Legrand & Marie Beylot-Barry

  2. Paul Valéry Montpellier 3, University of Montpellier, EPSYLON EA 4556, Montpellier, France

    Guillaume Broc

  3. INSERM UMR 1219, Bordeaux Population Health Research Center, Team: Handicap, Activity, Cognition, Health, University of Bordeaux, Bordeaux, France

    Bruno Quintard

  4. INSERM U1053, UMR Bariton, Oncogenesis of Cutaneous Lymphoma, University of Bordeaux, Bordeaux, France

    Marie Beylot-Barry

Authors
  1. Constance Garrouteigt
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  2. Guillaume Broc
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  3. Adeline Legrand
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  4. Bruno Quintard
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  5. Marie Beylot-Barry
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Contributions

All the authors had full access to all the data in the study. CG, MB-B, and BQ took responsibility for the integrity of the data and the accuracy of the data analysis. CG and MB-B wrote the manuscript. BQ, GB and AL reviewed the paper and provided important advice. All authors, especially CG, BQ, and GB, participated in elaboration of semi-structured interview guides.

Corresponding author

Correspondence to Marie Beylot-Barry.

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None to declare.

Ethic approval

The work was approved by Health Service Research Ethics Committee (approval no. IRCB 2018-A00200-55), the Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), and the Commission Nationale de l’Informatique et des Libertés (CNIL No. 2167944).

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Garrouteigt, C., Broc, G., Legrand, A. et al. Facilitators of and obstacles to consultation in patients with advanced basal cell carcinoma: a French pilot study. Arch Dermatol Res 313, 829–835 (2021). https://doi.org/10.1007/s00403-020-02175-x

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  • DOI: https://doi.org/10.1007/s00403-020-02175-x

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