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A systematic review of symptomatic diagnosis of lung cancer

A systematic review of symptomatic diagnosis of lung cancer
A systematic review of symptomatic diagnosis of lung cancer
Background. Lung cancer (LC) is often diagnosed late when curative intervention is no longer viable. However, current referral guidelines (e.g. UK National Institute for Health and Care Excellence guidelines) for suspected LC are based on a weak evidence base.
Aim. The purpose of this systematic review is to identify symptoms that are independently associated with LC and to identify the key methodological issues relating to symptomatic diagnosis research in LC.
Methods. Medline, Ovid and Cumulative Index to Nursing and Allied Health Literature were searched for the period between 1946 and 2012 using the MeSH terms ‘lung cancer’ and ‘symptom*’. Quality of each paper was assessed using Scottish Intercollegiate Guidelines Network and Consolidated Criteria for Reporting Qualitative Research Checklists and checked by a second and third reviewer.
Results. Evidence regarding the diagnostic values of most symptoms was inconclusive; haemoptysis was the only symptom consistently indicated as a predictor of LC. Generally, evidence was weakened by methodological issues such as the lack of standardized data collection (recording bias) and the lack of comparability of findings across the different studies that extend beyond the spectrum of disease. Qualitative studies indicated that patients with LC experienced symptoms months before diagnosis but did not interpret them as serious enough to seek health care. Therefore, early LC symptoms might be under-represented in primary care clinical notes.
Conclusion. Current evidence is insufficient to suggest a symptom profile for LC across the disease stages, nor can it be concluded that classical LC symptoms are predictors of LC apart from, perhaps, haemoptysis. Prospective studies are now needed that systematically record symptoms and explore their predictive values for LC diagnosis.
Diagnostic accuracy, epidemiology, lung cancer, lung neoplasm, predictive value, symptoms
0263-2136
137-148
Shim, Joanna
e2666d72-5c28-4fe4-acdc-a740b9beef45
Brindle, Lucy
17158264-2a99-4786-afc0-30990240436c
Simon, Michael
6e9ad30e-c22f-455a-945e-98d77dcec479
George, Steve
bdfc752b-f67e-4490-8dc0-99bfaeb046ca
Shim, Joanna
e2666d72-5c28-4fe4-acdc-a740b9beef45
Brindle, Lucy
17158264-2a99-4786-afc0-30990240436c
Simon, Michael
6e9ad30e-c22f-455a-945e-98d77dcec479
George, Steve
bdfc752b-f67e-4490-8dc0-99bfaeb046ca

Shim, Joanna, Brindle, Lucy, Simon, Michael and George, Steve (2014) A systematic review of symptomatic diagnosis of lung cancer. Family Practice, 31, 137-148. (doi:10.1093/fampra/cmt076). (PMID:24347594)

Record type: Article

Abstract

Background. Lung cancer (LC) is often diagnosed late when curative intervention is no longer viable. However, current referral guidelines (e.g. UK National Institute for Health and Care Excellence guidelines) for suspected LC are based on a weak evidence base.
Aim. The purpose of this systematic review is to identify symptoms that are independently associated with LC and to identify the key methodological issues relating to symptomatic diagnosis research in LC.
Methods. Medline, Ovid and Cumulative Index to Nursing and Allied Health Literature were searched for the period between 1946 and 2012 using the MeSH terms ‘lung cancer’ and ‘symptom*’. Quality of each paper was assessed using Scottish Intercollegiate Guidelines Network and Consolidated Criteria for Reporting Qualitative Research Checklists and checked by a second and third reviewer.
Results. Evidence regarding the diagnostic values of most symptoms was inconclusive; haemoptysis was the only symptom consistently indicated as a predictor of LC. Generally, evidence was weakened by methodological issues such as the lack of standardized data collection (recording bias) and the lack of comparability of findings across the different studies that extend beyond the spectrum of disease. Qualitative studies indicated that patients with LC experienced symptoms months before diagnosis but did not interpret them as serious enough to seek health care. Therefore, early LC symptoms might be under-represented in primary care clinical notes.
Conclusion. Current evidence is insufficient to suggest a symptom profile for LC across the disease stages, nor can it be concluded that classical LC symptoms are predictors of LC apart from, perhaps, haemoptysis. Prospective studies are now needed that systematically record symptoms and explore their predictive values for LC diagnosis.

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More information

e-pub ahead of print date: 17 December 2013
Published date: 2014
Keywords: Diagnostic accuracy, epidemiology, lung cancer, lung neoplasm, predictive value, symptoms
Organisations: Faculty of Health Sciences, Primary Care & Population Sciences

Identifiers

Local EPrints ID: 360636
URI: https://eprints.soton.ac.uk/id/eprint/360636
ISSN: 0263-2136
PURE UUID: 8562ca31-d1c6-444e-8811-7d874654ca4f
ORCID for Lucy Brindle: ORCID iD orcid.org/0000-0002-8933-3754

Catalogue record

Date deposited: 19 Dec 2013 11:39
Last modified: 17 Sep 2019 00:49

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