RT Journal Article SR Electronic T1 Development of an intervention to expedite cancer diagnosis through primary care: a protocol JF BJGP Open JO BJGP Open FD Royal College of General Practitioners SP bjgpopen18X101595 DO 10.3399/bjgpopen18X101595 A1 Marian Andrei Stanciu A1 Rebecca-Jane Law A1 Sadia Nafees A1 Maggie Hendry A1 Seow Tien Yeo A1 Julia Hiscock A1 Ruth Lewis A1 Rhiannon T Edwards A1 Nefyn H Williams A1 Katherine Brain A1 Paul Brocklehurst A1 Andrew Carson-Stevens A1 Sunil Dolwani A1 Jon Emery A1 William Hamilton A1 Zoe Hoare A1 Georgios Lyratzopoulos A1 Greg Rubin A1 Stephanie Smits A1 Peter Vedsted A1 Fiona Walter A1 Clare Wilkinson A1 Richard D Neal A1 The WICKED Team on behalf of YR 2018 UL http://bjgpopen.org/content/early/2018/09/03/bjgpopen18X101595.abstract AB Background GPs can play an important role in achieving earlier cancer diagnosis to improve patient outcomes, for example through prompt use of the urgent suspected cancer referral pathway. Barriers to early diagnosis include individual practitioner variation in knowledge, attitudes, beliefs, professional expectations, and norms.Aim This programme of work (Wales Interventions and Cancer Knowledge about Early Diagnosis [WICKED]) will develop a behaviour change intervention to expedite diagnosis through primary care and contribute to improved cancer outcomes.Design & setting Non-experimental mixed-method study with GPs and primary care practice teams from Wales.Method Four work packages will inform the development of the behaviour change intervention. Work package 1 will identify relevant evidence-based interventions (systematic review of reviews) and will determine why interventions do or do not work, for whom, and in what circumstances (realist review). Work package 2 will assess cancer knowledge, attitudes, and behaviour of GPs, as well as primary care teams’ perspectives on cancer referral and investigation (GP survey, discrete choice experiment [DCE], interviews, and focus groups). Work package 3 will synthesise findings from earlier work packages using the behaviour change wheel as an overarching theoretical framework to guide intervention development. Work package 4 will test the feasibility and acceptability of the intervention, and determine methods for measuring costs and effects of subsequent behaviour change in a randomised feasibility trial.Results The findings will inform the design of a future effectiveness trial, with concurrent economic evaluation, aimed at earlier diagnosis.Conclusion This comprehensive, evidence-based programme will develop a complex GP behaviour change intervention to expedite the diagnosis of symptomatic cancer, and may be applicable to countries with similar healthcare systems.