How do patients use self-care to manage non-specific symptoms prior to a cancer diagnosis? A rapid review to inform future interventions to reduce delays in presentation to primary care

Abstract

Background:
Timely diagnosis of cancer is important for patient outcomes. Delay in the patient interval (time from symptom interpretation to seeking help) is often the longest throughout the cancer patient pathway. Factors extending this interval include; vague symptom profiles increasing the difficulty of symptom appraisal and individual demographics influencing help-seeking behaviours. An underexplored and potential source of delay in cancer diagnosis is associated with managing symptoms using self-care activities prior to presentation to healthcare.
Methods:
This study aimed to characterise the use of self-care activities in the context of managing non-specific symptoms, prior to cancer diagnosis and their effect on length of the patient interval. Eligible publications were identified using a rapid systematic review and their qualitative self-care data extracted and analysed using thematic synthesis.
Results:
Forty-five qualitative research papers between 2009-2024 were included in the final review. Self-care was used as part of an iterative process, often resulting in delayed presentation to healthcare, if methods were effective in managing non-specific symptoms. Across the literature, varying types of self-care activities were reported across all cancers with non-specific symptoms including; the use of over the counter or alternative medications, lifestyle changes and watchful waiting. The individual’s decision to self-care was either prompted externally by a healthcare professional (HCP) (e.g. community pharmacists) or prompted by the individual depending on the availability of at home remedies and medication. Patients used self-care when there was low perceived need to seek healthcare, to determine if healthcare was required or to avoid the use of healthcare. However, across the literature, there is limited evidence to understand the variation by cancer type, symptom and individual characteristics.
Conclusions:
The findings of this rapid review demonstrate self-care activities could hinder prompt help-seeking and delay cancer diagnosis among people who are experiencing non-specific cancer symptoms. However, more evidence is needed to understand which individual factors facilitate the adoption of self-care behaviours over prompt help-seeking, for non-specific cancer symptoms.