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D. Bowen
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P2.06 - Poster Session/ Screening and Early Detection (ID 219)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.06-005 - Lung Cancer Risk Perception: Findings from the PAIRS-COPD Study (ID 821)
09:30 - 09:30 | Author(s): D. Bowen
- Abstract
Background:
Detecting new or early lung cancer symptoms in people who have COPD is especially difficult as early signs of disease may be masked by existing chronic respiratory symptoms. Public awareness of lung cancer symptoms remains low despite recent media campaigns. A lack of knowledge and understanding of their condition and associated risks may account for patient symptom reporting delay. Over 60% of UK lung cancer patients are diagnosed at a stage where curative treatment is no longer an option. Early reporting and diagnosis can provide curative treatment options and improved outcomes. New, cost effective interventions that promote timely detection and diagnosis and that are acceptable to patients are required. Prospective Assessment of Incident Respiratory Symptoms (PAIRS-COPD) is a feasibility study that evaluated four-monthly telephone reviews of COPD patient’s respiratory symptoms, by a primary care nurse. This abstract presents findings that identify the intervention’s effectiveness in prompting symptom reporting and referral and explores participant’s perceptions of their chest condition and lung cancer risk.
Methods:
Mixed methods were used. Quantitative analysis of frequency of identification of indications for a chest X-ray was undertaken with COPD patients on a primary care register (n=77). A purposive sample (n=12) were selected for semi-structured telephone interviews (7 women and 5 men) to evaluate patient perceptions and experiences and acceptability of the intervention. Interviews were audio taped and transcribed. Thematic analysis was used.
Results:
Interviewees revealed that living with respiratory symptoms for protracted periods resulted in a high level of symptom tolerance. New symptoms were assumed to be an inevitable and expected part of their normal illness trajectory or of aging more generally. Awareness of prognostic implications and lung cancer risk was low. The interviewees reported the belief that decline was inevitable. This, combined with their worsening respiratory condition and high symptom tolerance, had made delay in reporting new or deteriorating symptoms inevitable. However, as a consequence of the intervention, symptoms recommended to prompt a chest X-ray by the National Institute of Clinical Excellence (NICE) were identified in 27% of the 77 volunteers over the 12-month study period. In 5%, criteria for an urgent lung cancer referral were met. Importantly, the interviewees described how the intervention was acceptable and accessible as it did not require additional travel and visits to the doctor. It successfully provided them with a more nuanced understanding of their chest condition, increased knowledge of early indicators of acute exacerbation and enhanced their self-management skills. The calls also heightened interviewees’ appreciation of their increased risk of lung cancer and awareness of the associated symptoms. They reported adopting more proactive help seeking behaviours.
Conclusion:
This study reveals how the PAIRS-COPD intervention can help COPD patients identify and report new symptoms that may otherwise be accepted or missed. In the study symptoms requiring further investigation and referral were uncovered surprisingly frequently. For a client group with a significant symptom burden, the lack of disruption was a primary reason for the acceptability of the intervention.
