Objectives: To determine what factors are associated with the time people take to consult with symptoms of lung cancer, with a focus on those from rural and socially deprived areas.
Design: Cross-sectional quantitative interview survey. Supplementary data obtained from medical case notes.
Setting: Three Scottish hospitals (two in Glasgow, one in NE Scotland).
Participants: 360 patients with newly diagnosed primary lung cancer.
Main outcome measures: Number of days from: 1) date of participant defined first symptom until date of presentation to a medical practitioner; 2) date of earliest symptom from a symptom checklist (derived from clinical guidelines) until date of presentation to a medical practitioner.
Results: 50% (179) of participants had symptoms for more than 14 weeks before presenting to a medical practitioner (median 99 days; interquartile range 31-381days); 75% (n=270) of participants had unrecognised lung cancer symptoms. No significant differences on time taken to consult with symptoms of lung cancer between rural and/or deprived participants compared with urban and/or affluent participants were found. Factors independently associated with increased time before consultation of symptoms were: living alone (p=0.002); a history of COPD (p=0.007); and longer pack years of smoking (p=0.008).
Conclusion: For many people with lung cancer, regardless of location and socio-economic status, the time between symptom onset and consultation was long enough to plausibly affect prognosis. Long-term smokers, those with COPD and/or living alone are at particular risk of taking longer to consult with symptoms of lung cancer and practitioners should be alert to this.