Anticipated Time to Seek Medical Advice for Possible Lung Cancer Symptoms and Barriers to Timely Presentation in Palestine: a National Cross-sectional Study

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2024 Feb 7

PMID 38326766

Authors

Mohamedraed Elshami

Nawras Sawafta

Ahmad Mansour

Mohammed Alser

Ibrahim Al-Slaibi

Hanan Abukmail

Hanan Shurrab

Shahd Qassem

Faten Darwish Usrof

Malik Alruzayqat

Wafa Aqel

Roba Nairoukh

Rahaf Kittaneh

Yousef Mahmoud Nimer Habes

Obaida Ghanim

Wesam Almajd Aabed

Ola Omar

Motaz Daraghma

Jumana Aljbour

Razan E M Elian

Areen Zuhour

Haneen Habes

Mohammed Al-Dadah

Shurouq I Albarqi

Bettina Bottcher

Nasser Abu-El-Noor

Affiliations

Soon will be listed here.

Abstract

Background: Lung cancer (LC) has poor survival outcomes mainly due to diagnosis at late stages. This study explored the anticipated time to seek medical advice for possible LC symptoms and barriers to early presentation in Palestine.

Methods: This cross-sectional study recruited adult participants from hospitals, primary healthcare centers, and public spaces of 11 governorates using convenience sampling. A modified, translated-into-Arabic version of the validated LC awareness measure was used to assess LC symptom awareness, the time needed to seek medical advice and barriers to early presentation.

Results: A total of 4762 participants were included. The proportion that would immediately seek medical advice for possible LC symptoms varied according to the symptoms' nature. For respiratory symptoms, this ranged from 15.0% for 'painful cough' to 37.0% for 'coughing up blood'. For non-respiratory symptoms, this ranged from '4.2% for 'unexplained loss of appetite' to 13.8% for 'changes in the shape of fingers or nails'. Participants with good LC symptom awareness were more likely to seek medical advice within a week of recognizing most LC symptoms. About 13.0% would delay their visit to see a doctor after recognizing an LC symptom. The most reported barriers were emotional with 'disliking the visit to healthcare facilities' (59.8%) as the leading barrier.

Conclusion: LC respiratory symptoms were more likely to prompt early seeking of medical advice. Good LC symptom awareness was associated with a higher likelihood of help-seeking within a week. Educational interventions are needed to promote LC awareness and address the perceived barriers to early presentation in low-resource settings, such as Palestine.

References

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(1):25. PMC: 6323678. DOI: 10.1186/s12885-018-5169-9. View

Elshami M, Bottcher B, Alkhatib M, Ismail I, Abu-Nemer K, Hana M . Perceived barriers to seeking cancer care in the Gaza Strip: a cross-sectional study. BMC Health Serv Res. 2021; 21(1):28. PMC: 7788935. DOI: 10.1186/s12913-020-06044-1. View

McCutchan G, Weiss B, Quinn-Scoggins H, Dao A, Downs T, Deng Y . Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review. BMJ Glob Health. 2021; 6(2). PMC: 7868297. DOI: 10.1136/bmjgh-2020-004213. View

Elshami M, Thalji M, Abukmail H, Al-Slaibi I, Alser M, Radaydeh A . Knowledge of cervical cancer risk factors among Palestinian women: a national cross-sectional study. BMC Womens Health. 2021; 21(1):385. PMC: 8561913. DOI: 10.1186/s12905-021-01510-2. View

Hall S, Holman C, Threlfall T, Sheiner H, Phillips M, Katriss P . Lung cancer: an exploration of patient and general practitioner perspectives on the realities of care in rural Western Australia. Aust J Rural Health. 2008; 16(6):355-62. DOI: 10.1111/j.1440-1584.2008.01016.x. View

Caswell G, Seymour J, Crosby V, Hussain A, Manderson C, Farnan S . Lung cancer diagnosed following an emergency admission: exploring patient and carer perspectives on delay in seeking help. Support Care Cancer. 2017; 25(7):2259-2266. DOI: 10.1007/s00520-017-3633-8. View

Halahleh K, Gale R . Cancer care in the Palestinian territories. Lancet Oncol. 2018; 19(7):e359-e364. DOI: 10.1016/S1470-2045(18)30323-1. View

Elshami M, Tuffaha A, Yaseen A, Alser M, Al-Slaibi I, Jabr H . Awareness of ovarian cancer risk and protective factors: A national cross-sectional study from Palestine. PLoS One. 2022; 17(3):e0265452. PMC: 8936444. DOI: 10.1371/journal.pone.0265452. View

Scott N, Crane M, Lafontaine M, Seale H, Currow D . Stigma as a barrier to diagnosis of lung cancer: patient and general practitioner perspectives. Prim Health Care Res Dev. 2015; 16(6):618-22. DOI: 10.1017/S1463423615000043. View

10.

Elshami M, Mansour A, Alser M, Al-Slaibi I, Abukmail H, Shurrab H . Current situation and future directions of lung cancer risk factor awareness in Palestine: a cross-sectional study. BMJ Open. 2023; 13(1):e061110. PMC: 9853137. DOI: 10.1136/bmjopen-2022-061110. View

11.

Burgess C, Potts H, Hamed H, Bish A, Hunter M, Richards M . Why do older women delay presentation with breast cancer symptoms?. Psychooncology. 2006; 15(11):962-8. DOI: 10.1002/pon.1030. View

12.

Smith S, Campbell N, Macleod U, Lee A, Raja A, Wyke S . Factors contributing to the time taken to consult with symptoms of lung cancer: a cross-sectional study. Thorax. 2008; 64(6):523-31. DOI: 10.1136/thx.2008.096560. View

13.

Aberle D, Adams A, Berg C, Black W, Clapp J, Fagerstrom R . Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011; 365(5):395-409. PMC: 4356534. DOI: 10.1056/NEJMoa1102873. View

14.

Elshami M, Dwikat M, Al-Slaibi I, Alser M, Mohamad B, Isleem W . Awareness of Colorectal Cancer Risk Factors in Palestine: Where Do We Stand?. JCO Glob Oncol. 2022; 8:e2200070. PMC: 9225594. DOI: 10.1200/GO.22.00070. View

15.

Emery J, Walter F, Gray V, Sinclair C, Howting D, Bulsara M . Diagnosing cancer in the bush: a mixed-methods study of symptom appraisal and help-seeking behaviour in people with cancer from rural Western Australia. Fam Pract. 2013; 30(3):294-301. DOI: 10.1093/fampra/cms087. View

16.

Shankar A, Roy S, Malik A, Rath G, Julka P, Kamal V . Level of Awareness of Various Aspects of Lung Cancer Among College Teachers in India: Impact of Cancer Awareness Programmes in Prevention and Early Detection. J Cancer Educ. 2015; 31(4):709-714. DOI: 10.1007/s13187-015-0960-7. View

17.

Elshami M, Abukmail H, Aqel W, Alser M, Al-Slaibi I, Shurrab H . Awareness of Palestinians about lung cancer symptoms: a national cross-sectional study. BMC Pulm Med. 2022; 22(1):135. PMC: 8991725. DOI: 10.1186/s12890-022-01923-1. View

18.

Elshami M, Usrof F, Alser M, Al-Slaibi I, Okshiya H, Ghithan R . Awareness of Palestinian Women About Breast Cancer Risk Factors: A National Cross-Sectional Study. JCO Glob Oncol. 2022; 8:e2200087. PMC: 10166356. DOI: 10.1200/GO.22.00087. View

19.

Murray S, Kutzer Y, Habgood E, Murchie P, Walter F, Mazza D . Reducing barriers to consulting a General Practitioner in patients at increased risk of lung cancer: a qualitative evaluation of the CHEST Australia intervention. Fam Pract. 2017; 34(6):740-746. DOI: 10.1093/fampra/cmx057. View

20.

Elshami M, Al-Slaibi I, Abukmail H, Alser M, Radaydeh A, Alfuqaha A . Knowledge of Palestinian women about cervical cancer warning signs: a national cross- sectional study. BMC Public Health. 2021; 21(1):1779. PMC: 8487127. DOI: 10.1186/s12889-021-11792-8. View