Clinical management

Avoiding delays in cancer diagnosis during pregnancy

Pregnancy can impact how we interpret symptoms and influence help-seeking for symptoms subsequently diagnosed as cancer.
20 semi-structured interviews were conducted with women diagnosed with cancer during or shortly after pregnancy, Jan-May 2022, exploring symptom appraisal, help-seeking and experience of cancer diagnosis during pregnancy. Thematic analysis was performed. Themes were mapped onto the Model of Pathways to Treatment.
Symptoms were often interpreted through the lens of pregnancy by participants and healthcare professionals.
Participants who found breast lumps were likely to suspect cancer and be referred promptly for investigation.
Most sought timely help, but some encountered health system delays, partly due to both the vague nature of their symptoms and the COVID-19 pandemic.

A full assessment is essential before attributing symptoms to pregnancy, to ensure timely referral and diagnosis of possible cancer.
Consider an audit of cancer diagnoses at your practice and reflect as a team on any potential delays to diagnosis and how these could be avoided. Have any of your team had experience of supporting a patient with cancer diagnosis during or shortly after pregnancy that they could share?

Read about the evidence informing this GEM here:

Patients with bladder and kidney cancer may experience diagnostic delays. A prospective mixed-methods study aimed to identify contributors to potential missed diagnostic opportunities.
Only one-third of patients with recurrent UTIs were referred as per guideline recommendations. Patients reported being prescribed repeated courses of antibiotics without a clinical review/ examination and experienced suboptimal communication of results.

When issuing treatment for UTIs do you routinely check if it is a recurrent infection? As other healthcare professionals are often involved, would a template be useful to prompt further review for recurrent infections?
Reflect on whether your practice has a clear process for following up patients with visible/ non-visible haematuria who need repeat testing at interval/ after treatment for a urinary tract infection. Perhaps this could make a useful audit topic for your GP registrar or practice pharmacist, after which they could implement a new pathway?

Read about the evidence informing this GEM here: