Awareness and help-seeking for early signs and symptoms of lung cancer: A qualitative study with high-risk individuals.

Mohamad M Saab,Caroline Kilty,Josephine Hegarty,Maidy O'Brien,Brendan Noonan,Serena Fitzgerald,Una Kennedy,Abigail Collins,Áine Lyng

doi:10.1016/j.ejon.2020.101880

Mohamad M Saab, Caroline Kilty + Show 7 more

Open Access

https://doi.org/10.1016/j.ejon.2020.101880

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Abstract

Lung cancer is the most common malignancy and the leading cause of cancer death globally. Lung cancer incidence and mortality are highest among socioeconomically deprived individuals. This study explored awareness and help-seeking for early signs and symptoms of lung cancer among high-risk individuals. Participation was sought from multiple community centres and organisations in high-incidence and socioeconomically deprived areas in Ireland. Semi-structured focus groups were conducted with individuals at risk for lung cancer. Data were analysed using thematic analysis. Five focus groups were conducted with 46 participants. Two themes were identified: (i) lung cancer awareness, beliefs, and experiences and (ii) help-seeking for early signs and symptoms of lung cancer. Participants had fragmented knowledge of lung cancer and associated this malignancy with death. Symptom change, persistence, seriousness, and family history of lung cancer served as triggers to help-seeking. General practitioners were identified as the first point of contact for symptoms of concern, yet their presumed negative attitudes towards smokers served as barriers to help-seeking. Other barriers included symptom misappraisal, fear, denial, use of self-help measures, being inherently a non-help seeker, and machoism and stoicism among men. Study findings offer guidance regarding lung cancer knowledge gaps and barriers to help-seeking that ought to be considered in public health interventions aimed to promote lung cancer awareness and early detection. This study highlights the need for healthcare professionals to adopt a non-judgmental approach during consults for symptoms indicative of lung cancer. This can potentially help detect lung cancer early.

Highlights

Lung cancer (LC) is the most common malignancy and the leading cause of cancer death globally (Torre et al, 2016)
In the United Kingdom (UK), the five-year relative survival rate for early-stage LC is 57% in comparison to 3% for patients diagnosed at an advanced stage (Cancer Research UK, 2020)
This study sheds light on awareness of LC and help-seeking in tentions for symptoms of concern among high-risk individuals living in socioeconomically deprived areas

Summary

Introduction

Lung cancer (LC) is the most common malignancy and the leading cause of cancer death globally (Torre et al, 2016). LC ranks first among invasive cancer deaths in Ireland, with a five-year relative survival rate of 17.9% which is comparable to global figures (National Cancer Registry Ireland, 2018; Wong et al, 2017). Symptom misappraisal and help-seeking delay can result from experiencing systemic and non-specific symptoms of advanced LC including fatigue and unexplained weight loss (American Cancer Society, 2019), as well as LC stigma (Carter- Harris, 2015). This may lead to more advanced-stage LC diagnoses and lower eligibility for curative treatment (Holmberg et al, 2010; Walter et al, 2015). Age-adjusted rates were approximately 60% higher for the ‘most’ compared with the ‘least’ deprived population quintiles, with urban males and females showing higher rates relative to rural individuals (Walsh et al, 2016)

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