Diagnostic delay in lung cancer: a qualitative study: Diagnostic delay in lung cancer (original) (raw)
Responding to symptoms suggestive of lung cancer: a qualitative interview study
BMJ open respiratory research, 2014
Late diagnosis of lung cancer can impact on survival rates. Patients delay seeking help for a number of reasons. This study explored symptom appraisal and help-seeking decisions among patients referred to specialist respiratory services with symptoms suggestive of lung cancer. In-depth qualitative interviews with patients as soon as possible after referral, ideally before diagnosis and mainly within 10 weeks, explored factors impacting on their pathways prior to referral. Framework analysis, underpinned by the Model of Pathways to Treatment, was used to explore the data with particular focus on patients' beliefs and experiences, disease factors and healthcare professional influences. 35 patients were interviewed (aged 41-88 years, 15 women, 17 with lung cancer). All described similar presenting symptoms and triggers to seek help. Appraisal of symptoms was influenced by whether they had a lung comorbidity; seriousness of symptoms was interpreted within the context of previous ill...
2022
Background Lung cancer is the leading cause of cancer incidence and mortality worldwide. Prompt patient help-seeking for signs and symptoms suggestive of lung cancer is crucial for early referral, diagnosis, and survivorship. However, patients diagnosed with lung cancer tend to delay help-seeking. This qualitative study explored perceived barriers to patient help-seeking and strategies to enhance help-seeking for lung cancer warning signs and symptoms from the perspective of primary healthcare professionals. Methods Semi-structured focus groups and individual interviews were conducted with 36 primary healthcare professionals. Data were collected via videoconferencing. Inductive thematic analysis was conducted. Results The following two themes were created from the data: (i) perceived barriers to patient help-seeking for signs and symptoms of concern and (ii) facilitating early patient presentation for signs and symptoms of concern. Some participants believed that the high cost of a ...
Patients’ Perceptions at Diagnosis: Lung Cancer Discovery and Provider Relationships
Cancer Nursing, 2022
Background: In the United States, most lung cancer cases are diagnosed at advanced stages, limiting treatment options and impacting survival. This study presents patients' perspectives on the complexity of factors influencing a lung cancer diagnosis. Lung cancer awareness regarding risks, symptoms, smoking behaviors, family history, and environmental factors can lead to preventative and early detection measures. Objective: To explore lung cancer patient perspectives on lung cancer awareness within the context of an earlier study to understand sleep-wake disturbances in adults with NSCLC. Methods: A content analysis was used to analyze the original de-identified longitudinal interview data collected from 26 patients diagnosed with lung cancer. Results: Of the original 26 participants, 16 participants were included in this secondary data analysis. The participants were primarily females (n=10), Caucasians (n=13) with ages ranging between 49-83 years. Half of the sample was diagnosed with stage IV lung cancer and a majority of the sample was on chemotherapy (n=10). Two key themes were identified: the lung cancer discovery, and the patient-physician relationship. Conclusions: Unspecific initial symptoms, lack of knowledge and screening, as well as fear of the diagnosis delayed seeking medical care. Patient-physician relationships were hindered by smoking-associated stigma, inadequate sharing of information, and lack of coordinated, holistic care. Positive communication strategies are critical between patients and providers to meet patients' specific needs. Implications for Practice: Educational interventions that enhance lung cancer awareness may improve prevention and screening actions, improve timely healthcare intervention, and reduce incidence and mortality. Lung cancer is a serious problem in the United States. In 2021, lung cancer was expected to continue as the second most common cancer in both genders and the first common cause
Facilitating early diagnosis of lung cancer amongst primary care patients: The views of GPs
European Journal of Cancer Care, 2017
Early diagnosis of lung cancer (LC) is a policy priority. However, symptoms are vague, associated with other morbidities, and frequently unrecognised by both patients and general practitioners (GPs). This qualitative study, part of a larger mixed methods study, explored GP views regarding the potential for early diagnosis of LC within primary care. Five focus group discussions (FGDs) were conducted with GPs (n = 16) at primary care practices (n = 5) across four counties in south England. FGDs were audiorecorded, transcribed verbatim and analysed using a framework approach. Four broad themes emerged: patients' reporting of symptoms; GP response to symptoms; investigating LC, and; potential initiatives for early diagnosis. GPs reported they often required high levels of suspicion to refer patients on to specialist respiratory consultations, and concerns of 'system overload' were prevalent. Greater access to more sensitive diagnostic investigations such as computed tomography, was argued for by some, particularly for symptomatic patients with negative chest X-rays. GPs challenged current approaches to promoting earlier diagnosis through national symptom awareness campaigns, arguing instead that interventions targeted at high-risk individuals might be more effective without burdening services already under pressure. Further work is needed to identify primary care patients who might most benefit from such targeted interventions.
Early diagnosis of lung cancer: evaluation of a community-based social marketing intervention
Thorax, 2012
Background Poor UK lung cancer survival rates may, in part, be due to late diagnosis. Objectives To evaluate the effectiveness of a mixedmethod community-based social marketing intervention on lung cancer diagnoses. Methods A public awareness campaign in conjunction with brief intervention training in general practices was piloted in six localities with a high lung cancer incidence. End points were self-reported awareness of lung cancer symptoms; intention to seek healthcare; chest x-ray referral rates in primary care; secular trends in the incidence of lung cancer and stage at diagnosis, compared before and after the intervention. Results 21% (128/600) (95% CI 18% to 25%) of the targeted population recalled something about the campaign. Compared with a responder in the control area, the odds of a responder in the intervention area saying that they would visit their general practitioner and request a chest x-ray for a cough was 1.97 times (95% CI 1.18 to 3.31, p¼0.01). Primary care chest x-ray referral rates increased by 20% in the targeted practices in the year following the intervention compared with a 2% fall in the control practices. The difference was highly significant, with an incidence rate ratio of 1.22 (95% CI 1.12 to 1.33, p¼0.001). There was a 27% increase in lung cancer diagnoses in the intervention area compared with a fall in the control area. The incidence rate ratio was 1.42 (95% CI 0.83 to 2.44 p¼0.199). Conclusion This is encouraging early evidence that an awareness and early recognition initiative may facilitate lung cancer diagnosis.
British journal of cancer, 2014
Not recognising a symptom as suspicious is a common reason given by cancer patients for delayed help-seeking; but inevitably this is retrospective. We therefore investigated associations between recognition of warning signs for breast, colorectal and lung cancer and anticipated time to help-seeking for symptoms of each cancer. Computer-assisted telephone interviews were conducted with a population-representative sample (N=6965) of UK adults age ≥ 50 years, using the Awareness and Beliefs about Cancer scale. Anticipated time to help-seeking for persistent cough, rectal bleeding and breast changes was categorised as >2 vs ≤ 2 weeks. Recognition of persistent cough, unexplained bleeding and unexplained lump as cancer warning signs was assessed (yes/no). Associations between recognition and help-seeking were examined for each symptom controlling for demographics and perceived ease of health-care access. For each symptom, the odds of waiting for >2 weeks were significantly increase...