Table Box 4.

 A deviant case: when poor‐prognosis results were given without the offer of monitoring

Unusually, patient P20 learned his poor‐prognosis results from a routine ophthalmology clinic, and learned of the 6‐monthly screening later.

Before receiving results

He worried that ‘every pain is a cancer’, and anticipated using poor‐prognosis results for life‐planning

If it’s [cancer] too far then I want to know that and all to live what I have got left …have to cram more in than I want to cram in just at present

After receiving the result

He felt neither informed nor reassured

The only thing I got was “there’s good ones, there’s bad ones and there’s medium ones” and I came up with the medium one… So I’m in limbo…I’m fit with a medium risk is that a good or bad chance? You don’t know do you?... I’m worried now that I’ve got it somewhere else, so every ache and pain in my body is cancer…so that’s not putting my mind at ease.

After learning of the screening programme

He felt no reduction in uncertainty

I understood that if they did this operation and sent it away for the test they’d be able to tell me whether it would go further, whether anything had broken away from it but that wasn’t the fact … Nobody could answer the question there.

Instead, he felt cared for

The follow‐up’s been fantastic …I’ll not say they are 100% perfect or what, they can’t promise anything but at least you know they’ve got their eye on it

This allowed him to avoid thinking of the future

I just put that [cancer] to one side and then just carry on … because that [monitoring] is my peace of mind. Without that I wouldn’t be doing half of what I’m doing … It’s gone more like back to normal.