A survey of lung cancer in rural and remote Aboriginal and Torres Strait Islander communities in Queensland: health views that impact on early diagnosis and treatment

Abstract

The two main barriers identified as impacting on quality healthcare were communication and follow-up processes. These could be addressed by service improvement activities.

Patient and carer perceived barriers to early presentation and diagnosis of lung cancer: a systematic review

“…exercise, diet could offset health risk); individual beliefs about cancer (denial of risk, avoidance of unpleasant knowledge, shame about smoking, fears about treatment and fatalism that cancer treatment will have little benefit)Symptom experience: lack of symptom presentationBirt et al (2014) d [10]M: qualitative(interviews)S: Hospital – email invitation sent to patients referred via urgent, routine and diagnostic routesEngland“white” and otherPatients (with lung cancer diagnosis and other respiratory conditions)35 (17 lung cancer patients)Limited access to healthcareMisattribution of symptoms; self-management of symptoms; inability to communicate symptoms/condition; competing responsibilitiesSymptom experience: co-morbidities masking respiratory changes, difficulty in recognising symptoms.Scott, Crane, Lafontaine, Seale & Currow (2015) a [31]M: qualitative(interviews)S: lung cancer support networksAustraliaNot reportedPatients and GPs30 (20 patients)Increased societal awareness of lung cancer as smoking related and being the ‘fault of the individual’ (increases stigma).Views of lung cancer as a ‘death sentence’ and severe health consequence of smoking (as portrayed in some anti-smoking messaging) meant that patients were hesitant to seek medical advice for symptoms; anticipation of stigma and blame from health professionals and general community.Black et al (2015) )c [27]M: qualitative(interviews)S: EDs – member of the clinical teamEngland“White British”Patients27 (4 lung cancer patients)Health care professional’s appraisal leading to patients re-evaluating their symptoms inappropriately (e.g. lung cancer misdiagnosed as asthma)Page, Bowman, Yang & Fong (2016) a [32]M: qualitative(interviews)S: flyer, approaching people on the street, local meetings, places of employment, community centres, and snowballingAustraliaAboriginal and Torres Strait Islander peoplesPatients, indigenous health workers and community members67 (2 patients)Lack of (public or private) transport to specialist health care; cost incurred in accessing careWagland et al (2016) [28]M: mixed methods(questionnaire, clinical records review and interviews)S: GP practices – participants identified via questionnaire mailed to themEngland“White”, mixed, “Black/Black British”, “Asian/British Asian”, Chinese, otherPatients908 (38 patient interviews)Difficulty accessing appointments and time wasted in waiting roomsParticipants’ ‘wait and see’ attitudes towards most symptoms; guilt for symptoms perceived as self-inflicted; fear among patients for wasting GP’s time; patients not fully reporting true smoking habits or symptomsCaswell et al (2017) [12]M: qualitative...…”

“…Five studies included multiple participant groups including patients, family and/or community members, GPs and other service providers [26, 29, 31, 32, 34]. However, as the purpose of this review was to identify barriers to early presentation and diagnosis of lung cancer specifically by patients and families or carers, only the statements made by these participants were included in our analysis.…”

“…in rural Australia) and competing responsibilities (e.g. in the United Kingdom) were identified as barriers to symptom presentation and diagnosis [10, 29, 32, 34, 35].…”

Measuring (and narrowing) the gap: The experience with attendance of Indigenous cancer patients for Radiation Therapy in the Northern Territory

“…A survey of Indigenous health workers in Queensland found lung cancer awareness and knowledge of healthcare pathways to be low, and the benefit of education courses for indigenous health professionals has been shown for rural and remote professionals in WA . Analysis of Indigenous patients attending a regional radiotherapy service in Western Australia recommended a supportive environment to address complex access challenges …”

ERS statement on harmonised standards for lung cancer registration and lung cancer services in Europe

“…There is evidence of significant variations in the prevalence of somatic mutations in adenocarcinoma of the lung based on ethnicity [29,30]. There is also evidence of variation in the route to accessing healthcare services based on patient ethnicity [31][32][33]. However, it is difficult to find one coding system for ethnicity that would capture the needs of every country in Europe.…”