{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T22:32:34Z","timestamp":1774391554759,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Head and neck cancer (HNC) is the eighth most common cancer in the United Kingdom. Survival rates improve when the cancer is diagnosed at an early stage, highlighting a key need to identify at\u2010risk patients. This study aimed to explore opportunistic HNC identification and referral by community pharmacists (CPs) using a symptom\u2010based risk assessment calculator, from the perspective of patients with a diagnosis of HNC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Purposive sampling was used to recruit patients from the HNC pathway in three large teaching hospitals in Northern England. Qualitative methodology was used to collect data through an iterative series of semistructured telephone interviews. Framework analysis was utilised to identify key themes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four main themes were constructed through the analytic process: (1) HNC presentation and seeking help; (2) the role of the CP; (3) public perception of HNC\u00a0and (4) the role of a symptom\u2010based risk calculator. Participants agreed that CPs could play a role in the identification and referral of suspected HNCs, but there were concerns about access as patients frequently only encounter the medicine\u00a0counter assistant when they visit the pharmacy. HNC symptoms are frequently attributed to common or minor conditions initially and therefore considered not urgent, leading to delays in seeking help. While there is public promotion for some cancers, there is little known about HNC. Early presentation of HNC can be quite variable, therefore raising awareness would help. The use of a symptom\u2010based risk calculator was considered beneficial if it enabled earlier referral and diagnosis. Participants suggested that it would also be useful if the public were made aware of it and could self\u2010assess their symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In principle, CPs could play a role in the identification and referral of HNC, but there was uncertainty as to how the intervention would work. Future research is needed to develop an intervention that would facilitate earlier identification and referral of HNC while not disrupting CP work and that would promote HNC and the risk calculator more widely.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Patient and public involvement and engagement (PPIE) was integrated throughout the project. Initially, the proposal was discussed during a Cancer Head and Neck Group Experience (CHANGE) PPIE meeting. CHANGE was set up to support HNC research in 2018. The group is composed of seven members (four female, three male) with an age range of 50\u201371 years, who were diagnosed at Sunderland Royal Hospital. A patient representative from the University of Sunderland PPIE group and a trustee of the Northern HNC Charity were recruited as co\u2010applicants. They attended project management group meetings and reviewed patient\u2010facing documentation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.13816","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T12:40:35Z","timestamp":1689597635000},"page":"2089-2097","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Is the early identification and referral of suspected head and neck cancers by community pharmacists feasible? A qualitative interview study exploring the views of patients in North East England"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1997-3027","authenticated-orcid":false,"given":"Susan M.","family":"Bissett","sequence":"first","affiliation":[{"name":"School of Dental Sciences Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Sturrock","sequence":"additional","affiliation":[{"name":"Department of Nursing Midwifery and Health Northumbria University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Carrozzo","sequence":"additional","affiliation":[{"name":"School of Dental Sciences Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Lish","sequence":"additional","affiliation":[{"name":"Directorate of Multiprofessional Education, NHS England North East &amp; Yorkshire Oral Health Improvement, Health Education England\u2013North East North Cumbria Newcastle Upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debora","family":"Howe","sequence":"additional","affiliation":[{"name":"Northern Head and Neck Cancer Charity (NHANCC) Northumberland UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Mountain","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Patient\/Public Involvement &amp; Engagement Group, Sunderland University Sunderland UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Nugent","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Sunderland Royal Hospital Sunderland UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"O'Hara","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat Department Freeman Hospital Newcastle upon Tyne UK"},{"name":"Population Health Sciences Institute Newcastle Univeristy Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Todd","sequence":"additional","affiliation":[{"name":"School of Pharmacy Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Wilkes","sequence":"additional","affiliation":[{"name":"School of Medicine University of Sunderland Sunderland UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip M.","family":"Preshaw","sequence":"additional","affiliation":[{"name":"School of Dentistry University of Dundee Dundee UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Cancer Research UK. Head and neck cancer incidence.\u00a0Accessed January 25 2023.https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/head-and-neck-cancers#heading-Zero"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3892\/ijo.2015.2990"},{"key":"e_1_2_11_4_1","unstructured":"Cancer Research UK. Head & neck cancer Incidence.2022.\u00a0Accessed December 22 2023.https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/statistics-by-cancer-type\/head-and-neck-cancers#heading-Zero"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605401"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605399"},{"key":"e_1_2_11_7_1","unstructured":"National Health Service. The Long Term Plan.2019. Accessed January 25 2023.https:\/\/www.longtermplan.nhs.uk\/publication\/nhs-long-term-plan\/"},{"key":"e_1_2_11_8_1","unstructured":"Cancer Research UK. Early Diagnosis Data Hub.\u00a0Accessed January 25 2023.https:\/\/crukcancerintelligence.shinyapps.io\/EarlyDiagnosis\/"},{"key":"e_1_2_11_9_1","unstructured":"National Health Service Digital. Case mix adjusted percentages of cancers diagnosed at stages 1 and 2 by CCG in England.\u00a02022.\u00a0Accessed January 25 2023.https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/case-mix-adjusted-percentage-of-cancers-diagnosed-at-stages-1-and-2-in-england"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.49"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192416723"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005764"},{"key":"e_1_2_11_13_1","unstructured":"Pharmaceutical Service Negotiating Committee. Pharmacy advice audit report.\u00a02022. Accessed January 25 2023.https:\/\/psnc.org.uk\/our-news\/psnc-publishes-2021-22-annual-report\/"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o1483"},{"key":"e_1_2_11_15_1","unstructured":"Pharmaceutical Service Negotiating Committee. Healthy living pharmacy awareness events.2022. 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Accessed February 2 2023.https:\/\/northerncanceralliance.nhs.uk\/pathway\/early-diagnosis\/supporting-primary-care\/"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.791"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23306"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2016.02.012"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-9824.2010.01042.x"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-023-01973-2"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2015.09.022"},{"key":"e_1_2_11_30_1","unstructured":"Northern Head and Neck Cancer Charity. Northern Head and Neck Cancer Charity Home.\u00a0Accessed February 2 2023.http:\/\/www.northernhancc.org\/"},{"key":"e_1_2_11_31_1","unstructured":"Macmillan Cancer Support. Signs and symptoms of head and neck cancer.\u00a02023.\u00a0Accessed February 2 2023.https:\/\/www.macmillan.org.uk\/cancer-information-and-support\/head-and-neck-cancer\/signs-and-symptoms-of-head-and-neck-cancer"},{"key":"e_1_2_11_32_1","unstructured":"Macmillan Cancer Support. Chat online for specialist cancer support.\u00a0Accessed February 2 2023.https:\/\/www.macmillan.org.uk\/cancer-information-and-support\/get-help\/emotional-help\/chat-online"},{"key":"e_1_2_11_33_1","unstructured":"Mouth Cancer Foundation. Self\u2010examination for mouth cancer.\u00a02023.\u00a0Accessed February 2 2023.https:\/\/www.mouthcancerfoundation.org\/self-examination\/"},{"key":"e_1_2_11_34_1","unstructured":"Mouth Cancer Foundation. Patient experiences of mouth cancer.\u00a02023.\u00a0Accessed February 2 2023.https:\/\/www.mouthcancerfoundation.org\/patient-experiences\/"},{"key":"e_1_2_11_35_1","unstructured":"PuttickH. Risk calculator sifts head and neck cancer patients.\u00a02023.\u00a0Accessed February 2 2023.https:\/\/muckrack.com\/helen-puttick\/articles"}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.13816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T04:53:02Z","timestamp":1694148782000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.13816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,17]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/hex.13816"],"URL":"https:\/\/doi.org\/10.1111\/hex.13816","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,17]]},"assertion":[{"value":"2023-02-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}