Early cancer diagnosis and community pharmacies - a systematic review.

Background 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 the recent years. Aim 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. Design and Setting Systematic review with narrative synthesis. Method Online searches of Medline, CINAHL, Cochrane CENTRAL, PsychInfo 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. Results 14134 titles and abstracts were screened, and 330 full text publications were reviewed by two independent reviewers. 52 publications were included in the review and reported on interventions targeting early diagnosis of colorectal (n=19), skin (n=8), lung (n=4), cervical (n=3), breast (n=2), head and neck (n=2), and mixed (n=14) cancers. The feasibility and acceptability of such interventions by community pharmacy staff, customers and 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. Conclusion 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.