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GPs ‘should use cancer risk’ to shock patients into lifestyle changes

GPs should warn people of their risk of getting cancer later in life to make them eat more healthily and exercise more, researchers have suggested.

Their study found GPs and nurses thought talking about cancer would have more power than describing cardiovascular disease risk, because people are more scared of cancer and take it more seriously.

Around 40% of all cancers are thought to be related to lifestyle factors such as smoking, drinking too much alcohol, poor diet, being overweight and lack of physical activity, the team from University of Cambridge said.

The GP academics argued that use of cancer risk tools – such as the QCancer tool currently used for patients with symptoms – could be used to explain to people what their individual 10-year risk of cancer is likely to be, based on their history and current lifestyle.

They asked 24 healthcare professionals – including both GPs and practice nurses – about using such tools to communicate cancer risk and how that could be incorporated into primary care.

Most of the interviewees said they would be happy to discuss cancer risk and there was a general consensus that this would be best focused on younger people, in their 20s and 30s, when lifestyle changes could have the greatest impact, the researchers reported.

But they also agreed that talking about cancer could cause anxiety, and warned practices would need specific funding and resources to start counselling people about cancer risk.

The researchers wrote: ‘This study showed that…. there is support for providing personalised cancer risk information in general practice.’

They added that the findings highlighted a number of potential benefits and challenges, such as ‘the power of the word “cancer” to motivate lifestyle change, but recognition of its potential to also generate anxiety’ and ‘the challenge of finding the right time and place to provide the risk information’ and ‘need for additional resources, including funding, time, referral pathways… and training’.

RCGP chair Professor Helen Stokes-Lampard said that, while the study showed GPs ‘are open to greater use of “risk assessment tools” to encourage patients to make conscious lifestyle choices’, cancer risk assessment scores ‘aren’t an exact science’.

She also warned that younger patients who are most likely to benefit are also those who are ‘less likely to visit their GP – and if they do, it probably won’t be to discuss their risk of cancer’.

Professor Stokes-Lampard added: ‘Whilst we and our teams have a role in providing lifestyle advice for patients – and we do so on a daily basis – there is a limit to what GPs can do with the current resources and workforce available to us, and within the constraints of the standard 10-minute consultation, which is increasingly becoming unfit for purpose.’

Br J Gen Pr 2017; available online 14 February



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