Diagnostic delay in lung cancer: a qualitative study

Abstract

Lack of knowledge and awareness about lung cancer could be addressed by better education of the public. Social marketing is a way of developing education messages which tackle cultural influences on treatment-seeking delay. Nurses have a potential role in developing and disseminating those messages.

Social marketing and social influences: Using social ecology as a theoretical framework

“…Conversely, existing health education campaigns, particularly those related to smoking, may contain powerful "moral messages" (Corner et al, 2006(Corner et al, , P. 1388 contributing to fatalistic attitudes or a sense of stigma, in turn presenting barriers to early detection. Anti-smoking campaigns often stress the threat of lung cancer as a persuasive means to stop young people from taking up smoking or to encourage smoking cessation (Tod et al, 2008). Such campaigns generally do not provide information on the signs and symptoms and as a result may have negative consequences for concerned smokers (Corner et al, 2006).…”

“…Stoicism was found to be prevalent in older male participants, particularly those who had worked in traditional industrial occupations. Fatalistic beliefs, fear of diagnosis and subsequent death, feelings of stigma and blame and not wanting to waste the doctor"s time prevail (Alcalay & Bell, 2000;Eadie & MacAskill, 2007;Tod et al, 2008). Lifelong patterns and habits also contributed to a reluctance to use primary care services; older people often recalled pre-NHS healthcare (Tod et al, 2008).…”

“…Unlike breast cancer for example, there is no "lump" to find; early symptoms often appear minor and unspecific and can be attributed to other conditions or simply getting older (Ramirez et al, 1999); a tendency exaggerated among non-smokers (Tod et al, 2008).…”

“…Often, people present late for investigation, and survival rates in the UK are significantly worse than elsewhere in Europe (Cancer Research UK, 2007). Deprivation, social class, limited educational and other opportunities are associated with both a higher risk of developing lung cancer and reduced likelihood of survival (Corner, Hopkinson & Roffe, 2006;Tod, Craven, & Allmark, 2008) Explanations for this difference include greater barriers to accessing health services (Tod, Read, Lacey & Abbott, 2001) and higher levels of smoking (Cancer Research UK, 2007). While the obvious answer to lung cancer prevention is to target smoking, recent attention has also focused on the value of increasing symptom awareness with a view to early detection (Corner et al, 2006;Eadie & MacAskill, 2007).…”

Lived Experience among Patients Newly Diagnosed with Lung Adenocarcinoma Stage IV within One Year

“…Most people are less likely to see their doctor urgently if they display symptoms such as a constant cough or voice change. A prolonged delay is thought to take place between patients noticing symptoms and reporting them to a doctor (Tod, Craven, and Allmark, 2008). Only 15% of lung cancers are diagnosed at a localized stage, for which the 5-year survival rate is 54%.…”