Patients’ preferences for GP consultation for perceived cancer risk in primary care: a discrete choice experiment

Katriina L Whitaker, Alex Ghanouni, Yin Zhou, Georgios Lyratzopoulos, Stephen Morris

Contacting a doctor for advice when experiencing a potential cancer symptom is an important step in early diagnosis, but barriers to consultation are commonly reported. Understanding barriers to consulting in primary care within the cancer context provides opportunities to improve earlier diagnosis of cancer AIM: To investigate patients' GP consultation preferences when presented with a potential cancer symptom, and to describe whether these preferences are mediated by variable levels of cancer risk. A UK-wide online survey of adults ≥50 years old, using quota sampling to reflect general population characteristics. A discrete choice experiment examined participants' preferences for primary care consultation for three cancer symptom scenarios: risk level not mentioned, risk designated as 'low', or risk designated as 'high'. Scenarios based on length of consultation, time to getting an appointment, convenience, choice of GP, and GP listening skills were presented in a self-completed online questionnaire. A total of 9616 observations were obtained from 601 participants. Participants expressed preferences for doctors with better listening skills, the ability to see a GP of their choice, and shorter waiting times. These findings were the same across risk conditions and demographic groups. Participants were willing to wait an extra 3.5 weeks for an appointment with a doctor with good/very good listening skills (versus very poor listening skills) and an extra week for an appointment with a GP of their choice (versus any GP). Patient decisions about help seeking seem to be particularly influenced by the anticipated listening skills of doctors. Improving doctors' communication skills may in the longer term encourage people to seek prompt medical help when they experience a cancer symptom.