1
|
Signal V, Smith M, Costello S, Davies A, Dawkins P, Jackson CGCA, Koea J, Whitehead J, Gurney J. Indigenous access to clinical services along the lung cancer treatment pathway: a review of current evidence. Cancer Causes Control 2024:10.1007/s10552-024-01904-1. [PMID: 39150625 DOI: 10.1007/s10552-024-01904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Lung cancer is a deadly cancer. Early diagnosis and access to timely treatment are essential to maximizing the likelihood of survival. Indigenous peoples experience enduring disparities in lung cancer survival, and disparities in access to and through lung cancer services is one of the important drivers of these disparities. In this manuscript, we aimed to examine the current evidence on disparities in Indigenous access to services along the lung cancer treatment pathway. METHODS A narrative literature review was conducted for all manuscripts and reports published up until July 20, 2022, using Medline, Scopus, Embase, and Web of Science. Following the identification of eligible literature, full-text versions were scanned for relevance for inclusion in this review, and relevant information was extracted. After scanning 1,459 documents for inclusion, our final review included 36 manuscripts and reports that included information on lung cancer service access for Indigenous peoples relative to non-Indigenous peoples. These documents included data from Aotearoa New Zealand, Australia, Canada, and the USA (including Hawai'i). RESULTS Our review found evidence of disparities in access to, and the journey through, lung cancer care for Indigenous peoples. Disparities were most obvious in access to early detection and surgery, with inconsistent evidence regarding other components of the pathway. CONCLUSION These observations are made amid relatively scant data in a global sense, highlighting the need for improved data collection and monitoring of cancer care and outcomes for Indigenous peoples worldwide. Access to early detection and guideline-concordant treatment are essential to addressing enduring disparities in cancer survival experienced by Indigenous peoples globally.
Collapse
Affiliation(s)
- Virginia Signal
- University of Otago Wellington, Newtown, PO Box 7343, Wellington, 6242, New Zealand
| | - Moira Smith
- University of Otago Wellington, Newtown, PO Box 7343, Wellington, 6242, New Zealand
| | | | - Anna Davies
- University of Otago Wellington, Newtown, PO Box 7343, Wellington, 6242, New Zealand
| | - Paul Dawkins
- Te Whatu Ora - Counties Manukau, Auckland, New Zealand
| | | | | | | | - Jason Gurney
- University of Otago Wellington, Newtown, PO Box 7343, Wellington, 6242, New Zealand.
| |
Collapse
|
2
|
Paterson C, Roberts C, Blackburn J, Jojo N, Northam HL, Wallis E, Hind A, Caulfield R, Barratt M, Toohey K, Kavanagh PS, Bacon R, Wilson RL. Understanding the needs and preferences for cancer care among First Nations people: An integrative review. J Adv Nurs 2024; 80:1776-1812. [PMID: 38018290 DOI: 10.1111/jan.15968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
AIM This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people. DESIGN Integrative review. DATA SOURCES An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted. RESULTS Forty-two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person-centred cancer care services that address practical needs. CONCLUSION Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs. PATIENT OR PUBLIC CONTRIBUTION Our team includes both First Nations people, non-First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work. IMPLICATIONS FOR NURSING PRACTICE Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up-to-date cultural safety training and stand together with Indigenous and non-Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP.
Collapse
Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, UK
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - J Blackburn
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - N Jojo
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - H L Northam
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - E Wallis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - A Hind
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - R Caulfield
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - M Barratt
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - K Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Justice and Society, University of South Australia, Magill, South Australia, Australia
| | - R Bacon
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - R L Wilson
- School of Nursing and Midwifery, University of Newcastle, Gosford, New South Wales, Australia
- School of Nursing, Massey University, Palmerston North, New Zealand
- Descendent of the Wiradjuri Nation (First Nations Person), New South Wales, Australia
- Department of Nursing, RMIT University, Melbourne, Victoria, Australia
| |
Collapse
|
3
|
Gilroy J, Henningham M, Meehan D, Nila F, McGlone J, McAtamney A, Whittaker K, Brown B, Varlow M, Buchanan T. Systematic review of Aboriginal and Torres Strait Islander peoples' experiences and supportive care needs associated with cancer. BMC Public Health 2024; 24:523. [PMID: 38378574 PMCID: PMC10877816 DOI: 10.1186/s12889-024-18070-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Persistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia. METHODS A qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations. RESULTS Six key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings. CONCLUSION Future work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.
Collapse
Affiliation(s)
- John Gilroy
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Mandy Henningham
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Drew Meehan
- Cancer Council Australia, Sydney, NSW, 2000, Australia.
| | - Farhana Nila
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | | | | | - Bena Brown
- Inala Indigenous Health Service, Metro South Health, Inala, QLD, 4077, Australia
| | - Megan Varlow
- Cancer Council Australia, Sydney, NSW, 2000, Australia
| | - Tanya Buchanan
- Cancer Council Australia, Sydney, NSW, 2000, Australia
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| |
Collapse
|
4
|
Ali N, Nelson D, McInnerney D, Quaife SL, Laparidou D, Selby P, Kane R, Civello S, Skinner D, Pogson Z, Peake MD, Harding-Bell A, Cooke S. A systematic review on the qualitative experiences of people living with lung cancer in rural areas. Support Care Cancer 2024; 32:144. [PMID: 38316704 PMCID: PMC10844412 DOI: 10.1007/s00520-024-08342-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE To synthesize the qualitative literature exploring the experiences of people living with lung cancer in rural areas. METHODS Searches were performed in MEDLINE, CINAHL, and PsycINFO. Articles were screened independently by two reviewers against pre-determined eligibility criteria. Data were synthesized using Thomas and Harden's framework for the thematic synthesis of qualitative research. The CASP qualitative checklist was used for quality assessment and the review was reported in accordance with the ENTREQ and PRISMA checklists. RESULTS Nine articles were included, from which five themes were identified: (1) diagnosis and treatment pathways, (2) travel and financial burden, (3) communication and information, (4) experiences of interacting with healthcare professionals, (5) symptoms and health-seeking behaviors. Lung cancer diagnosis was unexpected for some with several reporting treatment delays and long wait times regarding diagnosis and treatment. Accessing treatment was perceived as challenging and time-consuming due to distance and financial stress. Inadequate communication of information from healthcare professionals was a common concern expressed by rural people living with lung cancer who also conveyed dissatisfaction with their healthcare professionals. Some were reluctant to seek help due to geographical distance and sociocultural factors whilst others found it challenging to identify symptoms due to comorbidities. CONCLUSIONS This review provides a deeper understanding of the challenges faced by people with lung cancer in rural settings, through which future researchers can begin to develop tailored support to address the existing disparities that affect this population.
Collapse
Affiliation(s)
- Nabilah Ali
- Lincoln Medical School, College of Health and Science, Universities of Nottingham and Lincoln, Lincoln, LN6 7TS, UK
| | - David Nelson
- College of Health and Science, Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, LN6 7TS, UK
- Macmillan Cancer Support, London, SE1 7UQ, UK
| | - Daisy McInnerney
- Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Samantha L Quaife
- Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Despina Laparidou
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, LN6 7TS, UK
| | - Peter Selby
- Lincoln Medical School, College of Health and Science, Universities of Nottingham and Lincoln, Lincoln, LN6 7TS, UK
- School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, Lincoln, LN6 7TS, UK
| | - Sarah Civello
- Lincoln County Hospital, United Lincolnshire Hospitals NHS Trust, Lincoln, LN2 5QY, UK
| | - Dawn Skinner
- Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston, PE21 9QS, UK
| | - Zara Pogson
- Lincoln County Hospital, United Lincolnshire Hospitals NHS Trust, Lincoln, LN2 5QY, UK
| | - Michael D Peake
- Cancer Research UK, London, E20 1JQ, UK
- Glenfield Hospital, University of Leicester, Leicester, LE1 7RH, UK
| | - Ava Harding-Bell
- Swineshead Patient Participation Group, Swineshead Medical Group, Boston, PE20 3JE, UK
| | - Samuel Cooke
- College of Health and Science, Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, LN6 7TS, UK.
| |
Collapse
|
5
|
Adams SJ, Stone E, Baldwin DR, Vliegenthart R, Lee P, Fintelmann FJ. Lung cancer screening. Lancet 2023; 401:390-408. [PMID: 36563698 DOI: 10.1016/s0140-6736(22)01694-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/26/2022] [Accepted: 08/25/2022] [Indexed: 12/24/2022]
Abstract
Randomised controlled trials, including the National Lung Screening Trial (NLST) and the NELSON trial, have shown reduced mortality with lung cancer screening with low-dose CT compared with chest radiography or no screening. Although research has provided clarity on key issues of lung cancer screening, uncertainty remains about aspects that might be critical to optimise clinical effectiveness and cost-effectiveness. This Review brings together current evidence on lung cancer screening, including an overview of clinical trials, considerations regarding the identification of individuals who benefit from lung cancer screening, management of screen-detected findings, smoking cessation interventions, cost-effectiveness, the role of artificial intelligence and biomarkers, and current challenges, solutions, and opportunities surrounding the implementation of lung cancer screening programmes from an international perspective. Further research into risk models for patient selection, personalised screening intervals, novel biomarkers, integrated cardiovascular disease and chronic obstructive pulmonary disease assessments, smoking cessation interventions, and artificial intelligence for lung nodule detection and risk stratification are key opportunities to increase the efficiency of lung cancer screening and ensure equity of access.
Collapse
Affiliation(s)
- Scott J Adams
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Emily Stone
- Faculty of Medicine, University of New South Wales and Department of Lung Transplantation and Thoracic Medicine, St Vincent's Hospital, Sydney, NSW, Australia
| | - David R Baldwin
- Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Pyng Lee
- Division of Respiratory and Critical Care Medicine, National University Hospital and National University of Singapore, Singapore
| | - Florian J Fintelmann
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| |
Collapse
|
6
|
Basnayake TL, Valery PC, Carson P, De Ieso PB. Treatment and outcomes for indigenous and
non‐indigenous
lung cancer patients in the Top End of the Northern Territory. Intern Med J 2021; 51:1081-1091. [DOI: 10.1111/imj.14961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/03/2020] [Accepted: 06/15/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Thilini L. Basnayake
- Respiratory and Sleep Medicine Royal Darwin Hospital Darwin Northern Territory Australia
- School of Medicine Flinders University Darwin Northern Territory Australia
| | - Patricia C. Valery
- Population Health QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Philip Carson
- Department of Surgery Royal Darwin Hospital Darwin Northern Territory Australia
| | - Paolo B. De Ieso
- Department of Radiation Oncology Royal Darwin Hospital Darwin Northern Territory Australia
| |
Collapse
|
7
|
Carruthers S, Pennefather M, Ward L, Giam K, Penniment M. Measuring (and narrowing) the gap: The experience with attendance of Indigenous cancer patients for Radiation Therapy in the Northern Territory. J Med Imaging Radiat Oncol 2019; 63:510-516. [PMID: 31081995 DOI: 10.1111/1754-9485.12887] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/10/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Barriers exist for both Indigenous and remote patients attending cancer care facilities. We sought to measure clinical attendance of all patients referred for consideration of radiation therapy (RT) at the single radiation therapy centre in the Northern Territory (NT), with particular attention to a comparison of Indigenous and non-Indigenous patients, and to analyse methods introduced to address the attendance of patients. METHODS Patients referred for radiation therapy over a 5 year period from the commencement of the Alan Walker Cancer Care Centre (AWCCC), NT, were analysed for attendance, and for possible improvement over time. RESULTS Multivariate analysis of non-attendance prior to RT (pre-RT) showed significance for Indigenous status (P < 0.001), and female gender (P < 0.001), and during RT showed significance for Indigenous status (P < 0.001) and curative intent RT (P = 0.012). Attendance during RT over the 5 years showed significant improvement over time for Indigenous patients from 70.6% to 81.6% (P = 0.038). There was no significant improvement with pre-RT attendance for either the Indigenous or non-Indigenous cohort. CONCLUSION Indigenous patients experienced a lower level of attendance during RT, but this has significantly improved over the first 5 years of operation at AWCCC, as recognition and management of contributing factors has improved.
Collapse
Affiliation(s)
- Scott Carruthers
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Mary Pennefather
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Linda Ward
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kar Giam
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Michael Penniment
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| |
Collapse
|
8
|
Cassim S, Chepulis L, Keenan R, Kidd J, Firth M, Lawrenson R. Patient and carer perceived barriers to early presentation and diagnosis of lung cancer: a systematic review. BMC Cancer 2019; 19:25. [PMID: 30621616 PMCID: PMC6323678 DOI: 10.1186/s12885-018-5169-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/02/2018] [Indexed: 01/17/2023] Open
Abstract
Background Lung cancer is typically diagnosed at a late stage. Early presentation and detection of lung cancer symptoms is critical to improving survival but can be clinically complicated and as yet a robust screening method for diagnosis is not available in routine practice. Accordingly, the barriers to help-seeking behaviour and diagnosis need to be considered. This review aimed to document the barriers to early presentation and diagnosis of lung cancer, based on patient and carer perspectives. Methods A systematic review of databases was performed for original, English language articles discussing qualitative research on patient perceived barriers to early presentation and diagnosis of lung cancer. Three major databases were searched: Scopus, PubMed and EBSCOhost. References cited in the selected studies were searched for further relevant articles. Results Fourteen studies met inclusion criteria for review. Barriers were grouped into three categories: healthcare provider and system factors, patient factors and disease factors. Conclusions Studies showed that the most frequently reported barriers to early presentation and diagnosis of lung cancer reported by patients and carers related to poor relationships between GPs and patients, a lack of access to services and care for patients, and a lack of awareness of lung cancer symptoms and treatment. Addressing these barriers offers opportunities by which rates of early diagnosis of lung cancer may be improved.
Collapse
Affiliation(s)
- Shemana Cassim
- Waikato Medical Research Centre, University of Waikato, Hamilton, 3240, New Zealand.
| | - Lynne Chepulis
- Waikato Medical Research Centre, University of Waikato, Hamilton, 3240, New Zealand
| | - Rawiri Keenan
- School of Nursing, University of Auckland, Auckland, 1023, New Zealand
| | - Jacquie Kidd
- School of Nursing, University of Auckland, Auckland, 1023, New Zealand
| | - Melissa Firth
- Waikato Medical Research Centre, University of Waikato, Hamilton, 3240, New Zealand
| | - Ross Lawrenson
- Waikato Medical Research Centre, University of Waikato, Hamilton, 3240, New Zealand.,Waikato Medical Research Centre, Waikato DHB Campus, Waikato Hospital, Hamilton, 3240, New Zealand
| |
Collapse
|
9
|
Rich AL, Baldwin DR, Beckett P, Berghmans T, Boyd J, Faivre-Finn C, Galateau-Salle F, Gamarra F, Grigoriu B, Hansen NCG, Hardavella G, Jakobsen E, Jovanovic D, Konsoulova A, Massard G, McPhelim J, Meert AP, Milroy R, Mutti L, Paesmans M, Peake MD, Putora PM, de Ruysscher DK, Sculier JP, Schepereel A, Subotic DR, Van Schil P, Blum T. ERS statement on harmonised standards for lung cancer registration and lung cancer services in Europe. Eur Respir J 2018; 52:13993003.00610-2018. [DOI: 10.1183/13993003.00610-2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/03/2018] [Indexed: 12/25/2022]
Abstract
The European Respiratory Society (ERS) task force for harmonised standards for lung cancer registration and lung cancer services in Europe recognised the need to create a single dataset for use in pan-European data collection and a manual of standards for European lung cancer services.The multidisciplinary task force considered evidence from two different sources, reviewing existing national and international datasets alongside the results of a survey of clinical data collection on lung cancer in 35 European countries. A similar process was followed for the manual of lung cancer services, with the task force using existing guidelines and national or international recommendations for lung cancer services to develop a manual of standards for services in Europe.The task force developed essential and minimum datasets for lung cancer registration to enable all countries to collect the same essential data and some to collect data with greater detail. The task force also developed a manual specifying standards for lung cancer services in Europe.Despite the wide variation in the sociopolitical landscape across Europe, the ERS is determined to encourage the delivery of high-quality lung cancer care. Both the manual of lung cancer services and the minimum dataset for lung cancer registration will support this aspiration.
Collapse
|
10
|
Barriers to lung cancer care: health professionals' perspectives. Support Care Cancer 2016; 25:497-504. [PMID: 27726030 PMCID: PMC5196009 DOI: 10.1007/s00520-016-3428-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/26/2016] [Indexed: 11/01/2022]
Abstract
PURPOSE Globally, lung cancer is the most common cancer and the leading cause of cancer death. Problematically, there is a wide variation in the management and survival for people with lung cancer and there is limited understanding of the reasons for these variations. To date, the views of health professionals across relevant disciplines who deliver such care are largely absent. The present study describes Australian health professionals' views about barriers to lung cancer care to help build a research and action agenda for improving lung cancer outcomes. METHODS Qualitative semi-structured interviews were undertaken with a multidisciplinary group of 31 Australian health professionals working in lung cancer care for an average of 16 years (range 1-35 yrs.; SD = 10.2) seeing a mean of 116 patients annually. RESULTS Three superordinate themes were identified: illness representations, cultural influences, and health system context. Illness representations included three themes: symptoms attributed as smoking-related but not cancer, health-related stigma, and therapeutic nihilism. Cultural influence themes included Indigenous health care preferences, language and communication, and sociodemographic factors. Health system context included lack of regional services and distance to treatment, poor care coordination, lack of effective screening methods, and health professional behaviours. CONCLUSIONS Fractured and locally isolated approaches routinely confound responses to the social, cultural and health system complexities that surround a diagnosis of lung cancer and subsequent treatment. Improving outcomes for this disadvantaged patient group will require government, health agencies, and the community to take an aggressive, integrated approach balancing health policy, treatment priorities, and societal values.
Collapse
|