title: Diagnostic delay in lung cancer: a qualitative study.
abstract: OBJECTIVE
  This paper is a report of a study to identify factors influencing delay in reporting symptoms of lung cancer.
  
  
  BACKGROUND
  Lung cancer accounts for approximately 5% of deaths in the Western world. For up to 80% of patients, their disease is inoperable because it has been diagnosed too late. This suggests that reducing diagnostic delay could reduce mortality.
  
  
  METHODS
  This qualitative study was conducted from July 2005 to May 2006 in community and hospital settings in the United Kingdom. A purposive sample of people diagnosed with lung cancer in the previous 6 months (n = 18), and two 18-month survivors took part in individual interviews.
  
  
  RESULTS
  Participants reported a range of interrelating factors that influenced delay in reporting symptoms of lung cancer. Barriers to symptom reporting included symptom experience, lack of knowledge and fear. Blame and stigma because of smoking were also prevalent influences, as well as cultural factors, non-standard patterns of healthcare utilization and underlying stoical attitudes. The only factor to emerge as helpful in overcoming delay was the role families played.
  
  
  CONCLUSIONS
  Lack of knowledge and awareness about lung cancer could be addressed by better education of the public. Social marketing is a way of developing education messages which tackle cultural influences on treatment-seeking delay. Nurses have a potential role in developing and disseminating those messages.
authors.affiliation: Centre for Health and Social Care Research, Sheffield Hallam University, Collegiate Campus, Sheffield, UK. a.tod@shu.ac.uk
authors.forename: Angela M
authors.initials: AM
authors.lastname: Tod
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Craven
authors.forename: Peter
authors.initials: P
authors.lastname: Allmark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012017:Referral and Consultation / Q000592:standards*; D012907:Smoking / Q000401:mortality / Q000523:psychology*; D000074606:Smoking Prevention; D013997:Time Factors