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Citation

Smith SM, Campbell NC, MacLeod U, Lee AJ, Raja A, Wyke S, Ziebland SB, Duff EM, Ritchie LD & Nicolson MC (2009) Factors contributing to the time taken to consult with symptoms of lung cancer: a cross sectional study. Thorax, 64 (6), pp. 523-531. https://doi.org/10.1136/thx.2008.096560

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

Keywords
360; Affect; AREAS; Cancer; Clinical guidelines; Consultation; Cross Sectional Studies; data; DATE; Design; difference; factors; focus; Glasgow; guideline; guidelines; HISTORY; HOSPITALS; Interview; Living; location; LONG-TERM; medical; NUMBER; outcome; Outcome measures; PARTICIPANTS; patient; Patients; PEOPLE; PRACTITIONER; practitioners; primary; RANGE; risk; rural; Scotland; scottish; Smoking; socio-economic; Socioeconomic status; survey; Symptoms; time; URBAN

Journal
Thorax: Volume 64, Issue 6