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Factors contributing to the time taken to consult with symptoms of lung cancer: a cross sectional study
  1. Sarah M Smith (s.m.smith{at}abdn.ac.uk)
  1. University of Aberdeen, United Kingdom
    1. Neil C Campbell (n.campbell{at}abdn.ac.uk)
    1. University of Aberdeen, United Kingdom
      1. Una MacLeod (uml1j{at}clinmed.gla.ac.uk)
      1. University of Glasgow, United Kingdom
        1. Amanda J Lee (a.j.lee{at}abdn.ac.uk)
        1. University of Aberdeen, United Kingdom
          1. Amalraj Raja (amalraj.raja{at}abdn.ac.uk)
          1. University of Aberdeen, United Kingdom
            1. Sally Wyke (sally.wyke{at}stir.ac.uk)
            1. University of Stirling, United Kingdom
              1. Sue B Ziebland (sue.ziebland{at}dphpc.ox.ac.uk)
              1. University of Oxford, United Kingdom
                1. Eileen M Duff (eileenmduff{at}yahoo.co.uk)
                1. University of Glasgow, United Kingdom
                  1. Lewis D Ritchie (l.d.ritchie{at}abdn.ac.uk)
                  1. University of Aberdeen, United Kingdom
                    1. Marianne C Nicolson (m.nicolson{at}arh.grampian.scot.nhs.uk)
                    1. NHS, United Kingdom

                      Abstract

                      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.

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