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Dissertation

Lung Cancer Detection Through the Patient, Provider, and System Continuum

18 May 2020

Abstract

Lung cancer claims more lives than any cancer in the world and remains difficult to diagnosis at early stages. This dissertation examines barriers to diagnosing lung cancer, symptoms associated with lung cancer, and barriers to recommending low-dose computed tomography (LDCT) via a mixed-methods survey to medical providers in Alaska. Additionally, this dissertation explores the process experienced from recognition in a change of health to receiving a lung cancer diagnosis from a patient’s perspective. Finally, this data is merged to assess opportunities to improve lung cancer detection in Alaska. Barriers to diagnosing lung cancer include non-specific symptom presentation, patients’ dismissal of symptoms and late presentation, and failure of patients to return for follow-ups or diagnostic workups. Symptoms most commonly associated with lung cancer are hemoptysis, prolonged cough, and weight loss. The most frequent barriers to LDCT screening include a lack of patient awareness, lack of reimbursement knowledge, and cost. Themes consistent with lung cancer detection process from a patient’s perspective include symptom denial, symptom reductionism, and gradual impact on function. Opportunities to improve lung cancer detection comprise long-term systemic change, increased emphasis on prevention, and patient and provider education. Results from these studies indicate educational initiatives for patients and providers may assist with detecting lung cancer and increasing lung cancer screenings rates.

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KowalskiFrankL_PhD_CHP_2020.pdf
19 May 2020
Public
4.21 MB