Anticipated time to seek medical advice for possible lung cancer symptoms and barriers to timely presentation in Palestine: a national cross-sectional study
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
Mohamedraed Elshami
Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center
Nawras Sawafta
Faculty of Medicine, Al-Quds University
Ahmad Mansour
Faculty of Medicine, Al-Quds University
Mohammed Alser
Faculty of Medicine, Islamic University of Gaza
Ibrahim Al-Slaibi
Almakassed Hospital
Hanan Abukmail
International Medical Corps
Hanan Shurrab
Faculty of Pharmacy, Al-Azhar University of Gaza
Shahd Qassem
Faculty of Medicine, Al-Quds University
Faten Darwish Usrof
Department of a Medical Laboratory Sciences, Faculty of Health Sciences, Islamic University of Gaza
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.
