Early cancer diagnosis and community pharmacies: a systematic review.

Abstract

Patients with symptoms of suspected cancer usually present to general practice; however, they may present to other healthcare providers, such as community pharmacies. The clinical role of pharmacy staff has significantly increased in England in recent years. To describe the range of interventions targeting early cancer detection in community pharmacies globally; to summarise the outcomes of these interventions; to report on barriers and facilitators to delivering the interventions and on service users' and stakeholders' experiences with such interventions. Systematic review with narrative synthesis, of international literature, on community pharmacy-based early cancer detection. Online searches of Medline, CINAHL, Cochrane CENTRAL, PsycINFO, and Embase and UK-based relevant grey literature were performed. Interventions were defined as any intervention, initiative, or programme that focused on community pharmacy-based early cancer detection programmes. In total, 14 134 titles and abstracts were screened, and 330 full-text publications were reviewed by two independent reviewers. Of these, 52 publications were included in the review. They reported on interventions focusing on early diagnosis of colorectal (<i>n</i> = 19), skin (<i>n</i> = 8), lung (<i>n</i> = 4), cervical (<i>n</i> = 3), breast (<i>n</i> = 2), head and neck (<i>n</i> = 2), and mixed (<i>n</i> = 14) cancers. The feasibility and acceptability of such interventions by community pharmacy staff and customers/patients have been demonstrated in the included studies. Studies involving opportunistic identification of customers with suspected cancer symptoms in pharmacies recruited only a few participants. Robust, large-scale clinical trials are needed to demonstrate cost-effectiveness, delineate and inform the use of relevant clinical outcomes, and to explore arrangements for information sharing between community pharmacy and other healthcare settings.