Experiences of ‘traditional’ and ‘one-stop’ MRI-based prostate cancer diagnostic pathways in England: a qualitative study with patients and GPs

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this record ; Data sharing statement: All data requests should be submitted in writing to the corresponding author ; Objectives: This study aimed to understand and explore patient and GP experiences of ‘traditional’ and ‘onestop’ prostate cancer diagnostic pathways in England. Design: Qualitative study using semi-structured interviews, analysed using inductive thematic analysis Setting: Patients were recruited from National Health Service (NHS) Trusts in London and in Devon; GPs were recruited via National Institute for Health Research (NIHR) Clinical Research Networks. Interviews were conducted in person or via telephone. Participants: Patients who had undergone a magnetic resonance imaging (MRI) scan of the prostate as part of their diagnostic work-up for possible prostate cancer, and GPs who had referred at least one patient for possible prostate cancer in the preceding 12 months. Results: 22 patients (aged 47 – 80 years) and 10 GPs (6 female, aged 38 – 58 years) were interviewed. Patients described three key themes: cancer beliefs in relation to patient’s attitudes towards prostate cancer; communication with their GP and specialist having a significant impact on experience of the pathway; and pathway experience being influenced by appointment and test burden. GP interview themes included: the challenges of dealing with imperfect information in the current pathway; managing uncertainty in identifying patients with possible prostate cancer, and sharing this uncertainty with them, and other social, cultural and personal contextual influences. Conclusions: Patients and GPs reported a range of experiences and views of the current prostate cancer diagnostic pathways in England. Patients valued ‘one-stop’ pathways integrating prostate MRI and diagnostic consultations with specialists over the more traditional approach of several hospital appointments. GPs remain uncertain how best to identify patients needing referral for ...