Promoting lung cancer awareness, help-seeking and early detection: a systematic review of interventions

Saab, Mohamad M.; Fitzgerald, Sarah; Noonan, Brendan; Kilty, Caroline; Collins, Abigail; Lyng, Áine; Kennedy, Úna; O’Brien, Maidy; Hegarty, Josephine

doi:10.1093/heapro/daab016

Cited by 21 publications

(13 citation statements)

References 53 publications

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“…In keeping with patient education and strategies to improve LC help-seeking, a recent systematic review of interventions promoting LC awareness and help-seeking found that the National Health Service campaign ‘Be Clear on Cancer’ was instrumental in increasing help-seeking for LC symptoms and reducing barriers to help-seeking [ 35 – 38 ]. Indeed, help-seeking for cough increased by 63% during the campaign and by 46% 8 weeks later ( p < 0.001) [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Primary healthcare professionals’ perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study

et al. 2022

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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, individuals with potential lung cancer symptoms 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 general practitioner visit, long waiting times, and previous bad experiences with the healthcare system would deter patients from seeking help for symptoms of lung cancer. Perceived patient-related barriers to help-seeking related to the different emotions associated with a potential cancer diagnosis as well as stigma, embarrassment, and guilt felt by smokers. Sociodemographic factors such as drug use, homelessness, living in rural areas, and being male and older were also perceived to impede patient help-seeking. The negative impact of the COVID-19 pandemic on cancer help-seeking also featured strongly. Participants recommended several strategies to enable patients to seek help for symptoms of concern including targeted educational campaigns focussing on symptoms (e.g., cough) rather than behaviours (e.g., smoking), accessible and free health services, and using patients’ support networks. Conclusions Patient-related and healthcare system-related barriers to help-seeking for lung cancer warning signs and symptoms include cost of healthcare, cancer fear, and various sociodemographic factors. Participants suggested that increased awareness and early patient help-seeking for symptoms of concern could be achieved through targeted patient education, national campaigns, the use of community support networks, and free and accessible targeted screening services.

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Section: Discussionmentioning

confidence: 99%

Primary healthcare professionals’ perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study

et al. 2022

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“…Accordingly, the results of a pilot program in Malaysia focusing on educating women and health professionals showed a signi cant reduction in advanced cervical and breast cancer with costeffectiveness (39). Results of others studies showed that large-scale interventions including public awarness and education reduced proportion of cancer diagnosed at late stage (40,41).…”

Section: Discussionmentioning

confidence: 99%

Barriers to Early Diagnosis of Cervical Cancer: A mixed-method study in Côte d'Ivoire, West Africa

Plaisy

Boni²,

Coffie

et al. 2022

Preprint

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Background: Cervical cancer, a major public health problem in many developing countries, is usually associated with a poor survival related to an advanced disease at diagnosis. In Côte d’Ivoire and other developing countries with high cervical cancer prevalence, little is known about factors associated with advanced cervical cancer stages in a context of limited access to screening services.Methods: From May to July 2019, we conducted a cross-sectional study using a mixed, quantitative and qualitative method. Information on socio-demographic and history of the disease was extracted from a rapid case ascertainement study performed by the cancer registry of Côte d’Ivoire that enrolled all women diagnosed with cervical cancer between July 2018 and June 2019. In-depth semi-structured interviews were conducted among a subset of these women (12 women) and six healthcare providers to further capture barriers to early cervical cancer diagnosis. Factors associated with an advanced stage III, IV (according to FIGO classification) were estimated by a logistic regression model. Qualitative data were analyzed using a thematic analysis technique guided by the treatment pathway model and triangulated with quantitative data. Results: In total, 95 women with cervical cancer [median age=51 (IQR 42-59)] years, were included. Among them, 18.9% were living with HIV and only 9.5% were covered by a health insurance. The majority (71.5%) were diagnosed with advanced cervical cancer. Being HIV-uninfected (aOR=5.4; [1.6-17.8], p=0.006) and being uninsured (aOR=13.1; [2.0-85.5], p=0.007) were independently associated with advanced cervical cancer in multivariate analysis. Qualitative data raised aditional factors potentially related to advanced cervical cancer stages at diagnosis including the lack of information on cervical cancer among healthcare providers and inadequate awareness and screening campaigns.Conclusion: In a context of challenges in access to systematic cervical cancer screening in Côte d'Ivoire, access to health insurance or integrated healthcare program appear to be key determinants of early diagnosis of cervical cancer.

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“…The following data were extracted for each study using a standardised table 14 , 24 (Supplementary Table 2 ): author(s); year; country; aim; design; theoretical underpinning; sample; setting; relevant outcomes; intervention; procedures; instruments; follow-up time(s); and relevant findings. One reviewer conducted data extraction.…”

Section: Methodsmentioning

confidence: 99%

“…However, a Swedish study found that patients diagnosed with LC experience, on average, a 6-month delay between symptom onset and initiation of treatment 13 . Reasons for delayed patient help-seeking include patient factors, such as symptom misappraisal, fear of a potential cancer diagnosis, and guilt associated with smoking 14 , 15 , as well as healthcare system factors, such as the high financial cost of healthcare, lack of access to healthcare, and previous bad experiences with the healthcare system 15 – 18 .…”

Section: Introductionmentioning

confidence: 99%

A systematic review of interventions to recognise, refer and diagnose patients with lung cancer symptoms

Saab

McCarthy

O’Driscoll

et al. 2022

npj Prim. Care Respir. Med.

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Patients with lung cancer (LC) often experience delay between symptom onset and treatment. Primary healthcare professionals (HCPs) can help facilitate early diagnosis of LC through recognising early signs and symptoms and making appropriate referrals. This systematic review describes the effect of interventions aimed at helping HCPs recognise and refer individuals with symptoms suggestive of LC. Seven studies were synthesised narratively. Outcomes were categorised into: Diagnostic intervals; referral and diagnosis patterns; stage distribution at diagnosis; and time interval from diagnosis to treatment. Rapid access pathways and continuing medical education for general practitioners can help reduce LC diagnostic and treatment delay. Awareness campaigns and HCP education can help inform primary HCPs about referral pathways. However, campaigns did not significantly impact LC referral rates or reduce diagnostic intervals. Disease outcomes, such as LC stage at diagnosis, recurrence, and survival were seldom measured. Review findings highlight the need for longitudinal, powered, and controlled studies.

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Promoting lung cancer awareness, help-seeking and early detection: a systematic review of interventions

Cited by 21 publications

References 53 publications

Primary healthcare professionals’ perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study

Primary healthcare professionals’ perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study

Barriers to Early Diagnosis of Cervical Cancer: A mixed-method study in Côte d'Ivoire, West Africa

A systematic review of interventions to recognise, refer and diagnose patients with lung cancer symptoms

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