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aWhitworth Chemists, Scunthorpe, UK, bDurham University, Stockon-on-Tees, UK, cUniversity of Sunderland, Sunderland, UK Patients with cancer alarm symptoms frequently present at the community pharmacy. Cough lasting longer than 3 weeks is the most common alarm symptom. There is scope to develop an intervention around promoting early cancer detection the community pharmacy. As cancer causes significant morbidity and mortality worldwide, healthcare professionals Etoposide must be aware of patients presenting with ‘alarm symptoms’ that are Hormones antagonist potentially indicative of underlying cancers. These symptoms include: haematuria, haemoptysis, dysphagia and rectal bleeding. Alarm symptoms can be suggestive of an underlying malignancy but can also be associated with undiagnosed chronic conditions. Typically, patients present to a GP with alarm symptoms, but in view of the advantages around accessibility, community pharmacy can provide an additional point of access for promotion of cancer early cancer detection. However, before interventions can be designed to promote early cancer detection in the community pharmacy,

it is important to quantify and characterize cancer alarm symptoms presented in this setting. The aim of the study was, therefore, to: (1) assess the incidence of cancer alarm symptoms in a community

pharmacy setting; and (2), determine the demographics of patients presenting with the alarm symptom. This was a prospective study conducted across 32 community pharmacies in the North of England from September 2013 to November 2013. To achieve the study aims, all of the pharmacy staff were provided with additional education and training around alarm symptoms, which involved discussing the relevance of symptoms and how to question patients sensitively without causing them undue alarm or stress. A data collection tool was used to establish the incidence of alarm symptoms; a list of symptoms was also left on each pharmacy counter as a prompt for the pharmacy staff. The following nearly data were recorded: alarm symptom(s) exhibited, gender, ethnicity and age of the patient, and the date and time presented. All patients presenting with alarm symptoms were given appropriate advice and referred to their GP for further investigation. This work was registered as a clinical audit and thus ethics approval was not required. Incidence of each presenting alarm symptom was not recorded and patients were not followed up after initial presentation; we acknowledge these limitations in our study. During the study period, a total of 257 alarm symptoms were observed amongst patients presenting in community pharmacies.