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    P3.11 - Screening and Early Detection (Not CME Accredited Session) (ID 977)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.11-15 - Lung Cancer Symptom Perception and Intervention Preferences in the UK’s Most Deprived Communities: A Qualitative Study (ID 13283)

      12:00 - 13:30  |  Author(s): Kerry Hood

      • Abstract
      • Slides

      Background

      People at highest risk for lung cancer- current or former smokers, aged over 40 years, with serious lung comorbidity and living in areas of deprivation- are more likely to prolong presenting to a GP with symptoms, leading to advanced stage diagnosis. This qualitative study sought to understand the influences on early presentation with lung cancer symptoms and intervention preferences in a sample of high risk, highly deprived individuals.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Semi-structured interviews were conducted with 37 high risk participants recruited purposively according to age, lung comorbidity and smoking status from primary care practices in deprived areas of England, Scotland and Wales. A lung symptom attribution task was used to explore symptom interpretations, symptom presentation and beliefs surrounding lung cancer, underpinned by Leventhal’s Common Sense model. Four focus groups with members of the public and local stakeholders (healthcare professionals and community partners) were conducted to explore intervention preferences. Data were analysed using Framework method.

      4c3880bb027f159e801041b1021e88e8 Result

      Interviews

      All participants resided in the most deprived quintile and most were unemployed or seeking benefits, and/or rented social housing. Key themes were: fixation on short term health (chest infections) leading to avoidance of longer term health (lung cancer), and the importance of the relationship with their healthcare professional to facilitate or deter help seeking. Focusing on detecting and managing ‘treatable’ chest infections led to denial of symptoms of ‘inevitable and incurable’ lung cancer. For example, participants normalised haemoptysis. Feeling judged by healthcare professionals and unworthy of medical help because of residence in a disadvantaged area or smoking habit deterred help seeking. Some participants, particularly those without caring responsibilities, anticipated refusal of treatment for lung cancer, with some contemplating suicide.

      Focus groups

      Suggestions for intervention content included information to raise awareness of lung cancer symptoms, modify negative lung cancer beliefs and highlight the importance of earlier diagnosis. Multi-faceted interventions were suggested including talks and stands in community venues, led by a trained, non-judgemental facilitator.

      8eea62084ca7e541d918e823422bd82e Conclusion

      In the context of difficult life circumstances and stigma, individuals who are high risk for lung cancer manage their lung health in the short term. Fixation on the treatment and detection of immediate health concerns may lead to avoidance and denial of important lung cancer symptoms. Community based multi-faceted interventions are required to empower highly deprived individuals to seek timely help, using a non-judgmental and welcoming approach.

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