# Advice after urgent suspected cancer referral when cancer is not found in England: Survey of patients’ preferences and perceived acceptability

## TL;DR

This study explores what patients prefer regarding post-referral advice after urgent cancer suspicion when cancer is not found, highlighting a need for equitable and acceptable guidance.

## Contribution

The study identifies patient preferences and acceptability of post-USC advice, revealing disparities in acceptability among ethnic minorities and less-educated groups.

## Key findings

- Most patients were willing to receive advice, particularly about managing ongoing symptoms.
- Acceptability was lower among ethnic minority groups and those with lower education levels.
- Patients preferred receiving advice from doctors, either face-to-face or via telephone.

## Abstract

No standardised approach exists to provide advice after urgent suspected cancer (USC) referral when cancer is not found. This study aimed to assess preferences and acceptability of receiving advice after USC referral related to: 1) managing ongoing symptoms, 2) responding to early symptoms of other cancers, 3) cancer screening, 4) reducing risks of future cancer.

2,541 patients from two English NHS Trusts were mailed a survey 1–3 months after having no cancer found following urgent suspected gastrointestinal or head and neck cancer referral. Participants were asked about: willingness to receive advice; prospective acceptability; preferences related to mode, timing and who should provide advice; and previous advice receipt.

406 patients responded (16.0%) with 397 in the final analyses. Few participants had previously received advice, yet most were willing to. Willingness varied by type of advice: fewer were willing to receive advice about early symptoms of other cancers (88.9%) than advice related to ongoing symptoms (94.3%). Acceptability was relatively high for all advice types. Reducing the risk of future cancer advice was more acceptable. Acceptability was lower in those from ethnic minority groups, and with lower levels of education. Most participants preferred to receive advice from a doctor; with results or soon after; either face to face or via the telephone.

There is a potential unmet need for advice after USC referral when no cancer is found. Equitable intervention design should focus on increasing acceptability for people from ethnic minority groups and those with lower levels of education.