Background Delays in cancer diagnosis contribute to avoidable mortality and are frequently associated with missed opportunities in primary care. Structured safety-netting and appropriate referral are critical to timely diagnosis, yet implementation remains inconsistent. In Ireland, general practice is constrained by limited diagnostic access, heterogeneous IT systems, and a mixed public–private funding model. This study will assess the feasibility of a structured, team-based intervention—adapted from the ThinkCancer! programme—to improve recognition, follow-up, and referral of patients with potential cancer symptoms, focusing on lung, colorectal, upper gastrointestinal, ovarian, and bladder cancers. Objectives To evaluate the feasibility of delivering a structured safety-netting and referral intervention in Irish general practice. The study will assess implementation fidelity, recruitment and retention of practices and patients, integration into routine workflows, and completeness of process and economic data to inform a future definitive trial. Methods A pilot cluster randomised controlled trial will be conducted across 10– 15 general practices, with 150–200 patients presenting with symptoms potentially indicative of one of the target cancers. Practices will be randomised to receive the intervention or continue usual care. The intervention includes: A tailored online education module for the full general practice team; Development of a Cancer Safety Netting Plan(CSNP) for use in
daily workflows;
Appointment of a Cancer Safety Netting Champion(CSNC) to
support implementation.
Embedded process and economic evaluations will assess
implementation fidelity, staff and patient acceptability, and data
collection feasibility. Exploratory outcomes include documentation of
safety-netting activity, referral rates, and follow-up of unresolved
symptoms.
Expected Impact
This study will assess whether a structured, theory-informed intervention
is practical, acceptable, and scalable within Irish general practice.
Findings will directly inform the design of a future definitive trial
evaluating clinical and cost-effectiveness. More broadly,this work
addresses a recognised evidence gap in early cancer diagnosis and
supports national policy objectives to strengthen primary care-led cancer
detection.
