What are the reasons behind delayed presentation in smokers?

Problem

Previous research has shown that smokers often delay consulting their GP when they experience chest symptoms. As most cases of lung cancer are attributable to smoking, it is important to seek out the reasons behind those delays. This project focuses on participant’s experiences of their symptoms and the factors which influence their decision making in seeking primary care.

Approach

Qualitative interviews were carried out with a purposive sample of recently diagnosed lung cancer patients in North Wales, followed by three focus groups with current smokers. The interviews were designed to explore the experiences of lung cancer patients with particular reference to patient intervals and smoking related factors. Focus groups were designed to learn the views of current smokers on seeking primary care. Topic guides were built upon evidence gathered from systematic and narrative literature reviews. All data were fully transcribed and analysed using Nvivo software.

Findings

Analysis shows the complexity of patient intervals and that consulting decisions are influenced by a variety of factors. A lack of symptom awareness or a tendency to normalise symptoms was apparent in participants who had gradually accommodated their worsening health. Others believed that new symptoms were due to pre-existing health problems or were ‘normal for smokers’. Decreased risk perception and views on legitimate help seeking were also a feature of participant’s accounts.

Consequences

This study has found new and important insights into the consulting decisions of people who smoke and experience cancer symptoms. This deeper understanding will allow for further research into the development of interventions designed to encourage primary care usage potentially facilitating earlier diagnosis and improved outcomes.