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Responding to symptoms suggestive of lung cancer: a qualitative interview study

Birt, Linda, Hall, Nicola, Emery, Jon, Banks, Jon, Mills, Katie, Johnson, Margaret, Hamilton, Willie and Walter, Fiona M (2014) Responding to symptoms suggestive of lung cancer: a qualitative interview study. BMJ Open Respiratory Research, 1 (1). e000067. ISSN 2052-4439

Item Type: Article


Background 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.

Methods 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.

Results 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 illness experiences. Help-seeking was triggered when: symptoms failed to respond as expected; there was an increased awareness of symptoms of lung cancer; the public nature of a cough meant others were able to endorse help-seeking. Almost half visited the general practitioner (GP) two or more times before referral; during this period they reinterpreted initial symptoms and appraised new symptoms. The meaning given to symptoms changed over time and many became increasingly concerned they may have lung cancer. The GP played a role in ensuring timely further help-seeking but often there was little guidance on how to monitor symptoms or when to reconsult.

Conclusions Patients diagnosed with and without lung cancer had similar symptom pathways. Findings provide guidance for lung cancer awareness campaigns on the importance of social networks in endorsing patient help-seeking. The importance of appropriate advice, monitoring and safety-netting procedures by GPs for people presenting with symptoms suggestive of lung cancer is also highlighted.

BMJ Open Resp Res-2014-Birt-.pdf - Published Version

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Depositing User: Nicola Hall


Item ID: 6681
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ISSN: 2052-4439
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Date Deposited: 07 Oct 2016 14:44
Last Modified: 06 Feb 2020 10:28


Author: Linda Birt
Author: Nicola Hall
Author: Jon Emery
Author: Jon Banks
Author: Katie Mills
Author: Margaret Johnson
Author: Willie Hamilton
Author: Fiona M Walter


Social Sciences > Health and Social Care
Sciences > Health Sciences
Psychology > Psychology

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