Multilevel factors associated with delays in screening, diagnosis, and treatment for lung cancer-A mixed methods systematic review protocol.

Abstract

Factors affecting time to lung cancer care may occur at multiple levels of influence. Mixed-methods reviews provide an approach for collectively synthesizing both quantitative and qualitative data. Prior reviews on timeliness of lung cancer care have included only either quantitative or qualitative data, been agnostic of the multilevel nature of influencing factors, or focused on a single factor such as gender or socioeconomic inequalities. We aimed to update the literature on systematic reviews and identify multilevel factors associated with delays in lung cancer screening, diagnosis, and treatment. The proposed systematic review will be conducted in accordance with the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis specific for mixed methods systematic reviews. Reporting will be consistent with PRISMA guidelines. Medline (PubMed), CINAHL, and SCOPUS will be searched using validated search terms for lung cancer and factors, health disparities and time/delay. Eligible studies will include original articles with quantitative, qualitative, or mixed-methods designs that investigate health disparities in, risk factors for, or barriers to timely screening, confirmatory diagnosis, or treatment among patients with lung cancer or those at risk for lung cancer. Title, abstract, and full-text screening, study quality assessment, and data extraction will be conducted by two reviewers. A convergent integrated approach with thematic synthesis will be applied to synthesize the extracted and generated analytical themes. Findings from this review will inform the design of an intervention to address delays in lung cancer screening for high-risk persons, diagnosis of suspected lung cancer, and treatment of confirmed cases.