Protocol for a Programme of Mixed-Methods Policy Research to Inform Primary Care’s Role in Symptomatic Early Cancer Detection in Ireland

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Effective early detection within primary care pathways has the potential to significantly improve patient outcomes by expediting diagnosis and access to treatment. However, in Ireland, primary care’s role in cancer control remains underdeveloped, with challenges such as inconsistent access to diagnostic tools, referral delays, and fragmented care pathways, limiting its effectiveness. International comparisons highlight the potential for primary care to play a more integrated and proactive role in cancer control strategies, particularly in early detection. Aims This protocol outlines a mixed methods research programme designed to evaluate and enhance the role of primary care in early cancer detection in Ireland. The studies will assess current practices, compare international models, and develop targeted policy recommendations to enhance early detection capabilities in primary care settings. Methods The programme will consist of three interconnected studies. Study 1 will involve a documentary analysis of Irish cancer policies using a systematic content analysis framework. Study 2 will conduct a rapid review of international literature and policies on early cancer detection in primary care. Study 3 will synthesise findings from the first two studies with data gathered through semi-structured interviews and roundtable discussions involving healthcare professionals, policymakers, and patient advocates. Stakeholder engagement will be embedded throughout the process, with public and patient involvement (PPI) ensuring the relevance of the research to patient-centred care. Conclusion This programme aims to provide a comprehensive understanding of primary care’s role in early cancer detection and identify practical strategies for enhancing its effectiveness within Ireland’s healthcare system. The findings will inform policy and practice, with the ultimate goal of improving early diagnosis rates, optimising cancer care pathways, and contributing to better patient outcomes. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/8-102/v1", "name": "Protocol for a Programme of Mixed-Methods Policy Research to Inform..." } } ] } Home Browse Protocol for a Programme of Mixed-Methods Policy Research to Inform... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Pirie K, Jacob B, Adams J et al. Protocol for a Programme of Mixed-Methods Policy Research to Inform Primary Care’s Role in Symptomatic Early Cancer Detection in Ireland [version 1; peer review: awaiting peer review] . HRB Open Res 2025, 8 :102 ( https://doi.org/10.12688/hrbopenres.14106.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Protocol for a Programme of Mixed-Methods Policy Research to Inform Primary Care’s Role in Symptomatic Early Cancer Detection in Ireland [version 1; peer review: awaiting peer review] Katherine Pirie https://orcid.org/0009-0008-4725-6106 1 , Benjamin Jacob https://orcid.org/0000-0003-1119-064X 1 , Jack Adams 1 , Sara Burke https://orcid.org/0000-0001-9419-1642 2 , Una Kennedy 3 , Patrick Redmond 1 Katherine Pirie https://orcid.org/0009-0008-4725-6106 1 , Benjamin Jacob https://orcid.org/0000-0003-1119-064X 1 , [...] Jack Adams 1 , Sara Burke https://orcid.org/0000-0001-9419-1642 2 , Una Kennedy 3 , Patrick Redmond 1 PUBLISHED 10 Sep 2025 Author details Author details 1 Department of General Practise, RCSI Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin 02, Dublin, D02 YN77, Ireland 2 Centre for Health Policy and Management, Discipline of Public Health and Primary Care, Trinity College Dublin School of Medicine, Dublin 02, Dublin, Ireland 3 National Cancer Control Programme, Dublin 01, Dublin, D01 A3Y8, Ireland Katherine Pirie Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Benjamin Jacob Roles: Conceptualization, Formal Analysis, Methodology, Writing – Review & Editing Jack Adams Roles: Writing – Review & Editing Sara Burke Roles: Methodology, Supervision, Writing – Review & Editing Una Kennedy Roles: Writing – Review & Editing Patrick Redmond Roles: Conceptualization, Funding Acquisition, Supervision, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW Abstract Background Primary care is key in the early detection of cancer, often serving as the first point of contact for patients presenting with symptoms. Effective early detection within primary care pathways has the potential to significantly improve patient outcomes by expediting diagnosis and access to treatment. However, in Ireland, primary care’s role in cancer control remains underdeveloped, with challenges such as inconsistent access to diagnostic tools, referral delays, and fragmented care pathways, limiting its effectiveness. International comparisons highlight the potential for primary care to play a more integrated and proactive role in cancer control strategies, particularly in early detection. Aims This protocol outlines a mixed methods research programme designed to evaluate and enhance the role of primary care in early cancer detection in Ireland. The studies will assess current practices, compare international models, and develop targeted policy recommendations to enhance early detection capabilities in primary care settings. Methods The programme will consist of three interconnected studies. Study 1 will involve a documentary analysis of Irish cancer policies using a systematic content analysis framework. Study 2 will conduct a rapid review of international literature and policies on early cancer detection in primary care. Study 3 will synthesise findings from the first two studies with data gathered through semi-structured interviews and roundtable discussions involving healthcare professionals, policymakers, and patient advocates. Stakeholder engagement will be embedded throughout the process, with public and patient involvement (PPI) ensuring the relevance of the research to patient-centred care. Conclusion This programme aims to provide a comprehensive understanding of primary care’s role in early cancer detection and identify practical strategies for enhancing its effectiveness within Ireland’s healthcare system. The findings will inform policy and practice, with the ultimate goal of improving early diagnosis rates, optimising cancer care pathways, and contributing to better patient outcomes. READ ALL READ LESS Keywords Primary Care; General Practice; Cancer; Early Detection of Cancer; Mixed methods; Health Policy; Ireland Corresponding Author(s) Katherine Pirie ( [email protected] ) Close Corresponding author: Katherine Pirie Competing interests: No competing interests were disclosed. Grant information: Secondary Data Analysis Project (SDAP) 2023-033 This work was also was supported by the 2024 RCSI Research Summer School. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Pirie K et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Pirie K, Jacob B, Adams J et al. Protocol for a Programme of Mixed-Methods Policy Research to Inform Primary Care’s Role in Symptomatic Early Cancer Detection in Ireland [version 1; peer review: awaiting peer review] . HRB Open Res 2025, 8 :102 ( https://doi.org/10.12688/hrbopenres.14106.1 ) First published: 10 Sep 2025, 8 :102 ( https://doi.org/10.12688/hrbopenres.14106.1 ) Latest published: 10 Sep 2025, 8 :102 ( https://doi.org/10.12688/hrbopenres.14106.1 ) Background Global burden of cancer Cancer remains one of the leading causes of morbidity and mortality worldwide, with profound implications for healthcare systems and public health policies. Globally, cancer incidence continues to rise, driven by ageing populations, lifestyle factors, and environmental influences. In Ireland, cancer poses a particularly significant challenge, accounting for nearly 30% of registered deaths in 2022 1 . Projections from the National Cancer Registry of Ireland indicate that certain cancer incidence will more than double in men and almost double in women between 2015 and 2045 2 . These trends highlight the urgency of strengthening cancer control strategies, particularly in prevention and early detection, which are critical to improving survival rates and reducing the societal burden of cancer. Ireland’s cancer control strategy Ireland’s approach to cancer control has evolved over the last two decades, with the National Cancer Strategy 2017–2026 representing a cornerstone document for guiding national efforts 3 . This strategy outlines a comprehensive framework targeting prevention, early diagnosis, screening, treatment, survivorship, and palliative care. Its goals include reducing cancer incidence, improving survival outcomes, ensuring equitable access to timely care, and embedding research into practice. Despite these ambitious objectives, challenges remain. Persistent issues such as acute care pressures, workforce shortages, regional disparities in care quality, and suboptimal resource allocation have limited progress in achieving consistent cancer outcomes across the country 3 . Furthermore, much of the focus within Ireland’s cancer policy has been on specialist and acute care, with comparatively limited emphasis on primary care’s role in cancer control 3 . Role of primary care in early cancer detection Primary care plays a pivotal role in the early detection of cancer, often serving as the first point of contact for patients with undifferentiated symptoms. In Ireland, general practitioners (GPs) are responsible for recognising early warning signs, initiating diagnostic tests, and coordinating timely referrals to specialist services 4 . Evidence suggests that optimising primary care pathways can reduce delays in diagnosis, decrease emergency presentations, and improve overall cancer outcomes 4 , 5 . However, significant barriers hinder the effectiveness of primary care in Ireland. These include limited direct access to diagnostic tools, variability in referral practices, and inconsistent integration of primary care into the broader cancer care network 6 , 7 . The mixed public-private healthcare system further complicates equitable access to diagnostics and care coordination. Addressing these challenges requires targeted interventions, including clearer referral pathways, enhanced diagnostic capacity in primary care settings, and strengthened connections between primary and secondary care. International perspectives on primary care and cancer control Internationally, primary care has been recognised as a cornerstone of effective cancer control strategies. The International Cancer Benchmarking Partnership (ICBP) has provided valuable insights into variations in cancer outcomes across countries such as Australia, Canada, Denmark, Norway, Sweden, and the UK 8 . Key factors influencing these outcomes include the availability of direct access to diagnostic tests, structured referral pathways for non-specific symptoms, and the autonomy of primary care practitioners in decision-making 9 . Countries with well-integrated primary care systems often demonstrate faster cancer diagnoses and better survival rates. For instance, Denmark and Sweden have implemented managed diagnostic pathways and fast-track referral systems, which have been associated with reduced diagnostic delays and improved outcomes 10 . Learning from such models offers valuable opportunities for Ireland to adapt evidence-based practices to its unique healthcare context. However, adapting these international strategies requires careful consideration of Ireland’s mixed healthcare system, which combines public and private service delivery. Aim & objectives The overarching aim of this research is to analyse and enhance primary care’s role in early cancer detection in Ireland. Specifically, the research will: • Analyse existing cancer control policies in Ireland to assess the effectiveness and integration of primary care in early detection efforts. • Compare Ireland’s approach to international models to identify transferable practices and systemic improvements. • Develop evidence-based recommendations to strengthen the capacity and integration of primary care within Ireland’s cancer control framework. Methods Study design This study adopts a mixed-methods design, integrating qualitative approaches to examine primary care’s role in early cancer detection in Ireland. The research comprises three interlinked studies: (1) a documentary analysis of Irish cancer control policies using a systematic content analysis framework, (2) a comparative rapid review of international cancer control models, and (3) the synthesis of documentary analysis and rapid review findings for the development of evidence-based policy recommendations informed by stakeholder engagement in semi-structure interviews and roundtable discissions. The design ensures a systematic and comprehensive evaluation of current practices, international insights, and stakeholder perspectives. Reporting will adhere to the Standards for Reporting Qualitative Research (SRQR) guidelines by providing a detailed account of the study’s methodology, including participant selection, data collection procedures, analytical approach, and measures taken to ensure credibility, reflexivity, and rigor 11 . Context Ireland’s healthcare system is characterised by a mixed public-private model, with primary care largely delivered by General Practitioners (GPs) who act as gatekeepers for patient access to specialist care 10 , 12 . Cancer is a leading cause of morbidity and mortality in Ireland, with projected incidence rates expected to more than double in men and almost double in women between 2015 and 2045 13 . Although survival rates have improved over the past decade, disparities persist in diagnostic access and cancer outcomes, particularly in rural and underserved areas 14 , 15 . Addressing these challenges requires strengthening the integration of primary care into the cancer control pathway, as emphasised in the National Cancer Strategy 2017–2026. This research will focus exclusively on primary care’s role in symptomatic detection of cancer, excluding areas such as asymptomatic screening, cancer treatment, survivorship, and palliative care. Study 1: Documentary analysis of Irish cancer control policies Aim : To systematically evaluate Irish policy documents and strategies supporting early cancer detection in primary care, with a focus on implementation effectiveness and gaps in service delivery. Methods : The study will follow Bowen’s framework for qualitative document analysis 16 . Relevant documents, including policy papers, government reports, and guidelines, will be identified through systematic searches of electronic databases (e.g., PubMed, Scopus, Web of Science), grey literature sources (e.g., Health Service Executive reports, National Cancer Strategy documents) and snow balling techniques. Search Strategy : Search terms will include: “Primary Care” , “Early Cancer Detection” , “Health Policy” , “Ireland” , “General Practice”, a nd “Cancer Diagnosis” . Searches will include documents published in English from the year 2000 onwards. Inclusion and Exclusion Criteria : The review will include documents explicitly addressing primary care’s role in cancer detection in Ireland and exclude those solely focussed on secondary or tertiary care. Data Extraction & Analysis: A standardised data extraction template will be used to capture document details, focus areas, and key findings (refer to extended data- Table 1). Qualitative content analysis will be conducted to identify themes and sub-themes related to policy strengths, implementation barriers, and gaps in service delivery. Data Synthesis : The synthesis will integrate findings from various sources to construct a comprehensive overview of primary care’s current role in cancer detection in Ireland. It will focus on summarising key themes, identifying policy gaps, and highlighting areas requiring further investigation or immediate action. This phase aims to consolidate domestic data to set an understanding for subsequent studies, particularly before comparing with international models. Study 2: Comparative analysis of international cancer control models Aim : To identify best practices from international models of early cancer detection in primary care and evaluate their applicability to Ireland’s healthcare system. Methods : A rapid review methodology will be employed, following the guidance of the Cochrane Rapid Review Methods Group (RRMG) 17 , 18 . Search Strategy : Searches will be conducted in PubMed, Scopus, Web of Science, and Google Scholar, with additional grey literature sourced from global health organisations and government publications. The search will include terms such as "Primary Care", "Early Detection", “Cancer Screening”, "Health Policy", "Best Practices", "International Models", and "Healthcare Systems". The strategy will be designed to identify models that have shown efficacy in diverse healthcare systems. Given the rapid review nature, the search will be limited to the most recent and relevant publications, primarily focusing on documents published within the last ten years. Included documents will be those that detail primary care interventions, policies, or practices proven effective in cancer control and are applicable to mixed healthcare systems like Ireland's. Data Extraction and Analysis : A standardised data extraction template will capture details on model descriptions, effectiveness measures, and contextual factors. Thematic analysis will identify common features and variations in effective practices, including referral pathways, diagnostic access, and system integration. Data Synthesis : The synthesis phase will integrate findings from the rapid review to offer a comparative perspective that highlights actionable insights and innovative practices that could be considered for implementation in Ireland. Study 3: Development of policy recommendations Aim : To synthesise findings from the first two studies and develop evidence-informed, actionable policy recommendations to strengthen early cancer detection in primary care in Ireland. Methods : This study will integrate findings from the previous studies with new qualitative data obtained through expert interviews and policy roundtable discussions. These discussions will involve a broad spectrum of stakeholders, including healthcare professionals, policymakers, and patient advocates. The methodology is informed by the approach used in the study "Addressing Cancer Care Disparities Across the Cancer Care Continuum" 19 , which employed multi-stakeholder roundtable discussions and comprehensive environmental scans to ensure a holistic policy development process. Participants : Participants will be recruited from a pre-identified pool of healthcare professionals, policy experts, patient advocates, and other relevant stakeholders. A purposive sampling strategy will be employed to ensure that a wide range of perspectives are represented, particularly those with direct experience or expertise in primary care and cancer control. The target sample size for the interviews is expected to be between 15 and 20 participants, sufficient to reach thematic saturation as per the guidance of Guest, Bunce, and Johnson 20 . The policy roundtable will include approximately 10 to 15 participants to ensure a manageable yet diverse discussion. Data Collection : Semi-structured interviews will be conducted to gather insights related to primary care and early diagnosis of cancer. Additionally, a facilitated policy roundtable session will be organised, where stakeholders will collaboratively review and refine preliminary policy recommendations. Data Analysis and Synthesis : The qualitative data collected through expert interviews and policy roundtable discussions will undergo thematic analysis, following the approach outlined by Braun and Clarke 21 . The process will begin with the transcription of interview and discussion content, ensuring accuracy and fidelity to participants’ input. An initial coding framework will be developed, informed by key findings from the earlier documentary analysis and rapid review. This framework will provide a structured basis for systematically coding the data while remaining flexible to accommodate emergent themes. The coding process will be iterative, with the framework refined as the analysis progresses to ensure that all relevant insights are captured comprehensively. Thematic analysis will focus on identifying patterns and recurring issues, as well as uncovering challenges and opportunities related to primary care’s role in early cancer detection. This process will aim to illuminate practical barriers, system-level inefficiencies, and areas where primary care integration into cancer control strategies can be strengthened. The synthesis process will integrate insights derived from the thematic analysis with the findings from the earlier studies. By systematically comparing qualitative themes with the results of the documentary analysis and rapid review, areas of convergence and divergence will be explored in detail. This comparative approach will enable a deeper understanding of the broader policy landscape and help contextualise the qualitative findings within the existing evidence base. The final synthesis will focus on developing evidence-informed policy recommendations, grounded in the combined data from all three studies 22 . These recommendations will be designed to address identified gaps, align with national cancer control objectives, and support the implementation of actionable strategies to enhance the role of primary care in early cancer detection (refer to extended data: Table 2). Stakeholder engagement We will schedule regular interactions with healthcare providers, policymakers, patient advocacy groups, and research communities. These stakeholders will play a pivotal role in shaping the research process, providing diverse perspectives, and ensuring that the study addresses relevant and practical issues in cancer care. Public and Patient Involvement The PRiCAN PPIE group will be involved in the design, conduct, analyse, and dissemination of the research. Discussion This protocol presents a comprehensive mixed-methods approach to assessing and enhancing primary care’s role in early cancer detection within Ireland. By combining documentary analysis, rapid reviews, qualitative interviews, and stakeholder roundtable discussions, the study is designed to offer a detailed understanding of the policy landscape, systemic barriers, and actionable opportunities in cancer control. Its multidisciplinary methodology integrates diverse perspectives, including those of healthcare providers, policymakers, and patient advocates, ensuring that the study outcomes are relevant and grounded in real-world contexts. A core strength of this protocol is its incorporation of Patient and Public Involvement and Engagement (PPIE) throughout the research process. This participatory approach prioritises patient needs and public priorities, increasing the acceptability and practical applicability of the recommendations. The inclusion of international comparisons further enhances the study’s scope, providing evidence-based insights from models that have successfully integrated primary care into cancer control, offering opportunities for adaptation to Ireland’s unique healthcare system. Strengths and limitations The study is methodologically robust, using qualitative data sources to deliver a detailed understanding of primary care’s role in cancer detection. By addressing both structural barriers and clinical challenges, the research framework offers the potential for actionable insights that are grounded in both policy and practice. However, certain limitations must be acknowledged. The effectiveness of the proposed policy recommendations will depend significantly on stakeholder engagement during the expert interviews and roundtable discussions. Limited participation, lack of diversity among stakeholders, or insufficient representation of key groups (e.g., rural GPs or marginalised populations) could constrain the comprehensiveness of the findings. To mitigate this, the study has incorporated purposive sampling to ensure diversity in perspectives. Another limitation is the potential lack of generalisability of findings to healthcare systems outside Ireland, given the country’s unique public-private model. Nonetheless, the inclusion of international comparative analysis will provide insights into practices that could be tailored to other contexts, particularly in settings with mixed healthcare funding structures. Lastly, the limited availability of high-quality, directly relevant literature, particularly in the Irish context, may challenge the evidence base of the documentary analysis and rapid review phases. Implications for policy and practice The findings of this study are anticipated to have significant implications for healthcare policy, clinical practice, and cancer control strategies. From a policy perspective, the study seeks to address critical gaps in primary care integration into cancer detection pathways. These include strengthening referral systems, improving GP access to diagnostic tools, and fostering collaboration between primary and secondary care. Evidence-informed recommendations generated from this study can support the alignment of primary care with the goals of the National Cancer Strategy 2017–2026, enhancing early diagnosis efforts and contributing to improved patient outcomes. In clinical practice, the study is expected to highlight opportunities for improving the diagnostic capacity of primary care providers. This includes enhancing GP training and education, streamlining referral protocols, and reducing diagnostic delays. Such improvements could directly impact patient outcomes by promoting earlier cancer detection and timely treatment. Additionally, the study will identify areas where targeted professional development initiatives can help GPs refine their diagnostic and management skills for cancer patients. Beyond cancer detection, this protocol provides a structured framework for evaluating healthcare policies, which can be applied to other areas of health research. Its integration of qualitative methods with stakeholder engagement ensures that findings remain contextually relevant, while the inclusion of international evidence highlights scalable solutions that could inform broader health policy. Dissemination strategy To ensure the study’s findings are widely disseminated and effectively utilised, results will be shared through a combination of academic, professional, and public engagement channels. Findings will be published in peer-reviewed journals and presented at relevant national and international conferences to reach academic and research communities. Policymakers and stakeholders will be engaged through targeted briefings, policy roundtables, and tailored summary reports. Public engagement will be further enhanced through digital platforms, including institutional websites and social media, to ensure transparency and accessibility. Additionally, educational workshops will be organised to support primary care providers in implementing the study’s recommendations, facilitating practical applications in clinical settings. Conclusion This protocol provides a strategic, evidence-based approach to evaluating and improving primary care’s role in early cancer detection in Ireland. By combining policy analysis, international comparison, and stakeholder engagement, the study is designed to generate actionable recommendations that are aligned with both patient needs and national cancer control objectives. Ethics Ethical approval was not required for this protocol. Approval for the qualitative components (interviews and the policy roundtable) will be sought from the RCSI Research Ethics Committee prior to data collection. Data availability No data are associated with this article. This article is a research protocol, and as such, does not include any associated datasets. Datasets generated during the research will be made permanently available in an open-access repository, the Open Science Framework, ensuring they are accessible to the public and other researchers. Extended data Open Science Framework: Protocol for a programme of mixed-methods policy research to inform primary care’s role in symptomatic early cancer detection in Ireland, https://doi.org/10.17605/OSF.IO/M5EAD 23 This project contains the following extended data: Participant Informed Consent Form Information Sheet for Participants Interview Guide Document for Semi-structured Interviews Search Strategy for Documentary Analysis Roundtable Discussion Guide Template for Data Extraction for Documentary Analysis https://doi.org/10.17605/OSF.IO/4WZUM Framework for Presenting Policy Recommendations https://doi.org/10.17605/OSF.IO/4WZUM Data is available under the terms of the CC-By Attribution 4.0 International. Faculty Opinions recommended References 1. National Cancer Registry: Cancer in Ireland 1994-2022 annual statistical report of the National Cancer Registry. 2024. Reference Source 2. National Cancer Registry Ireland: Cancer projections 2005-2035 a summary. Reference Source 3. National Cancer Strategy 2017-2026. Department of Health, 2017. Reference Source 4. Emery JD, Shaw K, Williams B, et al. : The role of primary care in early detection and follow-up of cancer. Nat Rev Clin Oncol. 2014; 11 (1): 38–48. PubMed Abstract | Publisher Full Text 5. Aggarwal A, Simcock R, Price P, et al. : NHS cancer services and systems—ten pressure points a UK cancer control plan needs to address. Lancet Oncol. 2024; 25 (8): e363–73. PubMed Abstract | Publisher Full Text 6. Houses of the Oireachtas Committee on the Future of Healthcare Sláintecare report. Dublin: Houses of the Oireachtas, 2017; 191. Reference Source 7. Sláintecare Implementation Strategy and Action Plan 2021-2023. Department of Health, 2021. Reference Source 8. Butler J, Foot C, Bomb M, et al. : The International Cancer Benchmarking Partnership: an international collaboration to inform cancer policy in Australia, Canada, Denmark, Norway, Sweden and the United Kingdom. Health Policy. 2013; 112 (1–2): 148–55. PubMed Abstract | Publisher Full Text 9. Lynch C, Harrison S, Emery JD, et al. : Variation in suspected cancer referral pathways in primary care: comparative analysis across the International Benchmarking Cancer Partnership. Br J Gen Pract. 2023; 73 (727): e88–94. PubMed Abstract | Publisher Full Text | Free Full Text 10. Rose PW, Hamilton W, Aldersey K, et al. : Development of a survey instrument to investigate the primary care factors related to differences in cancer diagnosis between international jurisdictions. BMC Fam Pract. 2014; 15 (1): 122. PubMed Abstract | Publisher Full Text | Free Full Text 11. O’Brien BC, Harris IB, Beckman TJ, et al. : Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014; 89 (9): 1245–51. PubMed Abstract | Publisher Full Text 12. European Observatory on Health Systems and Policies, OECD: State of Health in the EU Ireland - Country Health Profile 2023. Paris: OECD Publishing, 2023. Reference Source 13. National Cancer Registry: Cancer incidence projections for IRELAND 2020-2045. 2019. Reference Source 14. O'Shea MT, Collins C, ICGP, et al. : Access to diagnostics used to detect cancer. April, 2016. Reference Source 15. National Cancer Registry: Cancer inequalities in Ireland by deprivation, 2004-2018. 2023. Reference Source 16. Bowen GA: Document analysis as a qualitative research method. Qual Res J. 2009; 9 (2): 27–40. Publisher Full Text 17. Tricco AC, Langlois EV, Straus SE, et al. : Rapid reviews to strengthen health policy and systems: a practical guide. World Health Organization, 2017; [cited 2024 Sep 10]. Reference Source 18. Garritty C, Hamel C, Trivella M, et al. : Updated recommendations for the Cochrane rapid review methods guidance for rapid reviews of effectiveness. BMJ. 2024; 384 : e076335. PubMed Abstract | Publisher Full Text 19. Winkfield KM, Regnante JM, Miller-Sonet E, et al. : Development of an actionable framework to address cancer care disparities in medically underserved populations in the United States: expert roundtable recommendations. JCO Oncol Pract. 2021; 17 (3): e278–93. PubMed Abstract | Publisher Full Text | Free Full Text 20. Guest G, Bunce A, Johnson L: How many interviews are enough?: An experiment with data saturation and variability. 2006; 18 (1): 59–82. Publisher Full Text 21. Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006; 3 (2): 77–101. Publisher Full Text 22. Pope C, Mays N, Papay J: Synthesizing qualitative and quantitative health evidence: a guide to methods. Sociol Health Illn. 2008; 30 (2): 330–1. 23. OSF. [cited 2024 Jul 21]. https://osf.io/ Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 10 Sep 2025 ADD YOUR COMMENT Comment Author details Author details 1 Department of General Practise, RCSI Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin 02, Dublin, D02 YN77, Ireland 2 Centre for Health Policy and Management, Discipline of Public Health and Primary Care, Trinity College Dublin School of Medicine, Dublin 02, Dublin, Ireland 3 National Cancer Control Programme, Dublin 01, Dublin, D01 A3Y8, Ireland Katherine Pirie Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Benjamin Jacob Roles: Conceptualization, Formal Analysis, Methodology, Writing – Review & Editing Jack Adams Roles: Writing – Review & Editing Sara Burke Roles: Methodology, Supervision, Writing – Review & Editing Una Kennedy Roles: Writing – Review & Editing Patrick Redmond Roles: Conceptualization, Funding Acquisition, Supervision, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information Secondary Data Analysis Project (SDAP) 2023-033 This work was also was supported by the 2024 RCSI Research Summer School. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 10 Sep 2025, 8:102 https://doi.org/10.12688/hrbopenres.14106.1 Copyright © 2025 Pirie K et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Pirie K, Jacob B, Adams J et al. Protocol for a Programme of Mixed-Methods Policy Research to Inform Primary Care’s Role in Symptomatic Early Cancer Detection in Ireland [version 1; peer review: awaiting peer review] . HRB Open Res 2025, 8 :102 ( https://doi.org/10.12688/hrbopenres.14106.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: AWAITING PEER REVIEW AWAITING PEER REVIEW ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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