Educational Interventions to Reduce Cancer Diagnostic Delays in Primary Care: A Scoping Review
摘要
Diagnostic delays contribute to poorer outcomes in cancer care. Because most symptomatic patients enter the healthcare system through general practice, educational interventions for primary care teams could lead to earlier investigation, referral, and follow-up. We mapped educational interventions in primary care designed to reduce diagnostic delays for cancer and described their formats, targeted behaviours, outcomes, and gaps. We undertook a scoping review using the PRISMA-ScR checklist. PubMed, Embase, Scopus, and Web of Science were searched from January 2000 to January 2026. We included studies (and protocols) describing or evaluating educational interventions for primary care clinicians and teams intended to improve the timeliness of symptomatic cancer diagnosis (for example, safety-netting, diagnostic activity, referral quality, or time-based outcomes). Data were charted and synthesised descriptively and thematically. Sixteen publications representing ten distinct intervention programmes were included. Interventions ranged from brief clinician teaching and educational outreach to simulation-based mastery learning, national or regional continuing medical education programmes, whole-practice workshops, and education bundled with electronic decision support or electronic safety-netting tools. Most evaluations reported improvements in clinician competence, confidence, or process proxies (for example, documentation quality or diagnostic activity). Only a small number of studies assessed time-based outcomes such as primary care interval or total diagnostic interval, and effects were mixed or null; several digital interventions were further constrained by workflow misfit and low uptake. Educational interventions in primary care can improve behaviours relevant to earlier cancer diagnosis, but evidence for reductions in diagnostic delays remains limited. Future work should integrate education with practice systems, use standardised interval definitions, and evaluate timeliness and equity outcomes. This review synthesises evidence to inform curriculum design and continuing professional development for primary care teams, focusing on teachable behaviours (diagnostic reasoning under uncertainty, safety-netting, and appropriate thresholding for investigation/referral) that can shorten diagnostic intervals for cancer.