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 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, of international literature, on community pharmacy-based early cancer detection.

[METHOD] 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.

[RESULTS] 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 ( = 19), skin ( = 8), lung ( = 4), cervical ( = 3), breast ( = 2), head and neck ( = 2), and mixed ( = 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.

[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.