Lung cancer symptom appraisal among people with chronic obstructive pulmonary disease: a qualitative interview study

Cunningham, Y., Wyke, S. , Blyth, K. G. , Rigg, D., Macdonald, S. , Macleod, U., Harrow, S., Robb, K. A. and Whitaker, K. L. (2019) Lung cancer symptom appraisal among people with chronic obstructive pulmonary disease: a qualitative interview study. Psycho-Oncology, 28(4), pp. 718-725. (doi: 10.1002/pon.5005) (PMID:30693608) (PMCID:PMC6492269)

Abstract

Objective: The incidence of lung cancer is four-times higher in people with Chronic Obstructive Pulmonary Disease (COPD) compared to the general population. Promotion of a shorter time from symptom onset to presentation is one potential strategy for earlier lung cancer diagnosis but distinguishing respiratory symptoms can be difficult. We investigated how the experience of COPD influences symptom appraisal and help-seeking for potential lung cancer symptoms. Methods: We conducted qualitative interviews with men (n=17) and women (n=23) aged 40-83 with COPD. Topic guides drew on the Integrated Symptom-Response Framework and covered symptom experience, interpretation, action, recognition, help-seeking, evaluation and re-evaluation. We used the Framework Method to analyse the data. Results: Participants said they attributed chest symptoms to their COPD; no other cause was considered. Participants said that family/friends noticed changes in their symptoms and encouraged help-seeking. Others felt isolated by their COPD because they could not get out, were fatigued, or were embarrassed. Participants visited health professionals frequently but increased risk of lung cancer was not discussed. Conclusions: Our study provides insight into different levels of influence on symptom appraisal and targets for intervention. Greater awareness of increased lung cancer risk and support to act on symptom changes is essential and could be achieved through a concerted information campaign. Health professionals working with people with COPD could also optimise appointments to support symptom appraisal of potential lung cancer symptoms.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wyke, Professor Sally and Cunningham, Dr Yvonne and MacLeod, Dr Una and Blyth, Professor Kevin and Robb, Professor Katie and Macdonald, Professor Sara
• Authors: Cunningham, Y., Wyke, S., Blyth, K. G., Rigg, D., Macdonald, S., Macleod, U., Harrow, S., Robb, K. A., and Whitaker, K. L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Social Scientists working in Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: Psycho-Oncology
• Publisher: Wiley
• ISSN: 1057-9249
• ISSN (Online): 1099-1611
• Published Online: 28 January 2019
• Copyright Holders: Copyright © 2019 The Authors
• First Published: First published in Psycho-Oncology 28(4):718-725
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
71188	1	How can we support people with Chronic Obstructive Pulmonary Disease to recognise and seek prompt help for potential lung cancer symptoms?	Kathryn Robb	Cancer Research UK (CRUK)	C9227/A21572	IHW - GENERAL PRACTICE & PRIMARY CARE