title: Reducing the time before consulting with symptoms of lung cancer: a randomised controlled trial in primary care.
abstract: BACKGROUND
  Most individuals with lung cancer have symptoms for several months before presenting to their GP. Earlier consulting may improve survival.
  
  
  OBJECTIVE
  To evaluate whether a theory-based primary care intervention increased timely consulting of individuals  with symptoms of lung cancer.
  
  
  METHODS
  Open randomised controlled trial comparing intervention with usual care in two general practices in north-east Scotland.
  
  
  METHODS
  Smokers and ex-smokers aged ≥55 years were randomised to receive a behavioural  intervention or usual care. The intervention comprised a single nurse consultation at participants' general practice and a self-help manual. The main outcomes were consultations within target times for individuals with new chest symptoms (≤3 days haemoptysis, ≤3 weeks other symptoms)  in the year after the intervention commenced, and intentions about consulting with chest symptoms at 1 and 6 months.
  
  
  RESULTS
  Two hundred and twelve participants were randomised and 206 completed the trial. The consultation rate for new chest symptoms in the intervention  group was 1.19 (95% confidence interval [CI] = 0.92 to 1.53; P = 0.18) times higher than in the usual-care group and the proportion of consultations within the target time was 1.11 (95% CI = 0.41 to 3.03; P = 0.83) times higher. One month after the intervention commenced, the  intervention group reported intending to consult with chest symptoms 31 days (95% CI = 7 to 54; P = 0.012) earlier than the usual care group, and at 6 months this was 25 days (95% CI = 1.5 to 48; P = 0.037) earlier.
  
  
  CONCLUSIONS
  Behavioural intervention in primary  care shortened the time individuals at high risk of lung disease intended to take before consulting with new chest symptoms (the secondary outcome of the study), but increases in consultation rates and the proportions of consultations within target times were not statistically significant.
authors: Environmental and occupational medicine and consultant respiratory physician, Institute of Medical Sciences, UK.
authors: Sarah
authors: S
authors: Smith
authors: Shona
authors: S
authors: Fielding
authors: Peter
authors: P
authors: Murchie
authors: Marie
authors: M
authors: Johnston
authors: Sally
authors: S
authors: Wyke
authors: Rachael
authors: R
authors: Powell
authors: Graham
authors: G
authors: Devereux
authors: Marianne
authors: M
authors: Nicolson
authors: Una
authors: U
authors: Macleod
authors: Phil
authors: P
authors: Wilson
authors: Lewis
authors: L
authors: Ritchie
authors: Amanda J
authors: AJ
authors: Lee
authors: Neil C
authors: NC
authors: Campbell
mesh_terms: D055088:Early Detection of Cancer; D005260:Female; D058006:General Practice; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration*; D011379:Prognosis; D012017:Referral and Consultation / Q000458:organization & administration*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects; D061665:Time-to-Treatment / Q000458:organization & administration*