Aims
Lung cancer remains the leading cause of cancer death in developed countries. There is growing evidence that earlier diagnosis of lung cancer is an important factor in improving outcomes. Despite this, there is surprisingly little qualitative research that documents lung cancer patients’ diagnostic pathway and beyond.
This study aimed to describe and document lung cancer diagnostic and treatment pathways based on lung cancer patient and carer narratives. This study is one component of a lung cancer implementation research program in the Australian setting.
Methods
We developed a semi structured qualitative interview schedule to conduct with patients and their caregivers. We recruited participants via treating clinician (respiratory physician or medical oncologist) by sending a personal invitation letter. All patients were at least 6 months post diagnosis at the time of first invitation and interviews were conducted by telephone or face-to-face, according to participant preference. Interviews were recorded, transcribed and coded using a coding framework developed by four members of the investigator team. Detailed patient pathway maps were drawn, documenting the key points as discussed by participants. We conducted a content analysis and developed qualitative themes to interpret patient journeys.
Results
Eighteen lung cancer patients participated in the qualitative interviews across two metropolitan and one rural site. The patient journey maps provided rich data to understand the complexity of pathways that patients experience in the lead up to their lung cancer diagnosis and subsequent treatment. We examined all the maps to identify common elements and areas of greatest variability. In particular we will highlight the variations between the metropolitan and rural sites and the apparent barriers and facilitators to timely diagnosis.
Conclusions
The patient journey through lung cancer diagnosis is complex. The maps illustrate the heterogeneity in the pathways of lung cancer patients. These data will inform lung cancer implementation research projects to address the diagnostic pathway and improve patient care.