Knowledge of the signs and symptoms and risk factors of lung cancer in Australia: mixed methods study

Abstract

BackgroundLung cancer is the leading cause of cancer death in Australia. There is potential that health promotion about the risks and warning signs of lung cancer could be used to reduce delays in symptom presentation when symptoms are first detected. This study investigated knowledge, attitudes and beliefs which might impact help-seeking behaviour and could provide insight into possible public health interventions in New South Wales (NSW).MethodsA convergent mixed method study design was used wherein data from 16 qualitative focus groups of residents (40+ years), purposefully recruited and stratified by smoking status, age and geography (metropolitan/regional), were compared with a CATI administered population-wide telephone survey (n = 1,000) using the Cancer Research UK cancer awareness measure (LungCAM). Qualitative findings were analysed thematically using NVIVO. Logistic regression analysis was used to investigate predictors of symptom knowledge in STATA. Findings were integrated using triangulation techniques.ResultsAcross focus groups, haemoptysis was the only symptom creating a sense of medical urgency. Life experiences evoked a ‘wait and see’ attitude to any health deterioration. Perceived risk was low amongst those at risk with current smokers preferring to deny their risk while former smokers were generally unaware of any ongoing risk. The quantitative sample consisted of females (62 %), 40–65 years (53 %), low SES (53 %), former (46 %) and current smokers (14 %). In quantitative findings, haemoptysis and dyspnoea were the most recognised symptoms across the sample population. Age (<65 years), sex (female) and high socio-economic status contributed to a higher recognition of symptoms. Smoking was recognised as a cause of lung cancer, yet ever-smokers were less likely to recognise the risk of lung cancer due to second-hand smoke (OR 0.7 95 % CI 0.5–0.9).ConclusionWhile there was some recognition of risk factors and symptoms indicative of lung cancer, there was disparity across the sample population. The qualitative findings also suggest that knowledge may not lead to earlier presentation; a lack of urgency about symptoms considered trivial, and smoking-related barriers such as stigma may also contribute to time delays in presentation. Public health interventions may be required to increase awareness of risk and emphasise the importance of seeking medical attention for ongoing symptoms.

Do the Number of Cigarettes Smokes per day Contribute to the Incident of Malignant Cancer?

“…Types of malignant cancer based on the result of this study were skin, liver, stomach and oral cavity cancer. This result has a contradiction with several studies that stated most of the type of cancer due to smoking habit is lungs cancer (Morris et al, 1997;Furrukh, 2013;Crane et al, 2016;Spits and Neefjes, 2016). However, previous studies stated that there are at least 17 types incident of cancer due to cigarette smoking behaviour (Baade, 2015; and >30 cigarettes per day and the risk of having cancer showed 93.8% and 95.5%, respectively.…”

“…According to Catsburg et al, (2015) smoking 20-29 and 30-39 cigarette per day as a heavy smokers and increased risk of breast cancer at (HR=1.14 and HR=1.10, respectively) and result study of Morris et al, (1997) stated that smoking >25 cigarette per day increased risk 18 times to be diagnosed with lung cancer. Most recent epidemiological studies also find the consistency positive association between smoking and any types of cancer (Gandini et al, 2008;Young et al, 2009;Hansen et al, 2013;Alexandrov, 2016;Crane et al, 2016;Sohn and Jung, 2016;Spits and Neefjes, 2016). In Alexandrov, 2016).…”

“…Smokers have a desire to stop smoking only after they have suffered with diseases due to smoking (Mannino, 2009). Although many studies have proven that smoking increases the risk of any types of cancer (Gandini et al, 2008;Young et al, 2009;Hansen et al, 2013;Alexandrov, 2016;Crane et al, 2016;Spits and Neefjes, 2016) and have shown the incident risk of cancer based on the number of cigarettes smoked per day but none of the studies have performed the validity of the measurement (Morris et al, 1997;Catsburg et al, 2015).…”

Lung cancer awareness and palliative care interventions implemented in Africa: A systematic scoping review’

“…People may delay help-seeking due to poor knowledge of lung cancer symptoms (12,13), or wait until the disease advances to a terminal stage (14,15). Lack of public awareness of lung cancer and recognition of what to do when symptoms develop contribute to this delay (16,17). Early recognition by patients about the signs and symptoms of lung cancer depends on their level of awareness (4).…”

“…Over 90% of patients with lung cancer are symptomatic at the time of diagnosis and experience two to three symptoms on average (27,28). Cough is the most common presenting symptom and has been noted to be a good prognostic indicator (14,17,27). It has also been shown that many patients will visit their general practitioner (GP) on more than one occasion before further investigation or onward referral (27).…”