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Title: The LEAD study protocol: a mixed-method cohort study evaluating the lung cancer diagnostic and pre-treatment pathways of patients from Culturally and Linguistically Diverse (CALD) backgrounds compared to patients from Anglo-Australian backgrounds.
Austin Authors: Mazza, Danielle;Lin, Xiaoping;Walter, Fiona M;Young, Jane M;Barnes, David J;Mitchell, Paul L R ;Brijnath, Bianca;Martin, Andrew;Emery, Jon D
Affiliation: Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia
The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
Sydney School of Public Health, Sydney Medical School, University of Sydney, Camperdown, Australia
Department of General Practice and Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Australia
NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
Social Gerontology Division, National Ageing Research Institute, Parkville, Australia
Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
University of Melbourne, Parkville, Australia
Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Australia
Issue Date: 21-Jul-2018
Date: 2018-07-21
Publication information: BMC cancer 2018; 18(1): 754
Abstract: Lung cancer is the leading cause of cancer mortality worldwide. Early diagnosis and treatment is a key factor in reducing mortality and improving patient outcomes. To achieve this, it is important to understand the diagnostic pathways of cancer patients. Patients from Culturally and Linguistically Diverse (CALD) are a vulnerable group for lung cancer with higher mortality rates than Caucasian patients. The aim of this study is to explore differences in the lung cancer diagnostic pathways between CALD and Anglo-Australian patients and factors underlying these differences. This is a prospective, observational cohort study using a mixed-method approach. Quantitative data regarding time intervals in the lung cancer diagnostic pathways will be gathered via patient surveys, General practitioner (GP) review of general practice records, and case-note analysis of hospital records. Qualitative data will be gathered via structured interviews with lung cancer patients, GPs, and hospital specialists. The study will be conducted in five study sites across three states in Australia. Anglo-Australian patients and patients from five CALD groups (i.e., Arabic, Chinese, Greek, Italian and Vietnamese communities) will mainly be identified through the list of new cases presented at lung multidisciplinary team meetings. For the quantitative component, it is anticipated that 724 patients (362 Anglo-Australian and 362 CALD patients) will be recruited to obtain a final sample of 290 (145 per group) assuming a 50% patient survey completion rate and a 80% GP record review completion rate. For the qualitative component, 60 interviews with lung cancer patients (10 Anglo-Australian and 10 patients per CALD group), 20 interviews with GPs, and 20 interviews with specialists will be conducted. This is the first Australian study to compare the time intervals along the lung cancer diagnostic pathway between CALD and Anglo-Australian patients. The study will also explore the underlying patient, healthcare provider, and health system factors that influence the time intervals in the two groups. This information will improve our understanding of the effect of ethnicity on health outcomes among lung cancer patients and will inform future interventions aimed at early diagnosis and treatment for lung cancer, particularly patients from CALD backgrounds. The project was retrospectively registered with Australian New Zealand Clinical Trials Registry (registration number: ACTRN12617000957392 , date registered: 4th July 2017).
DOI: 10.1186/s12885-018-4671-4
Journal: BMC cancer
PubMed URL: 30031382
Type: Journal Article
Subjects: Cancer diagnostic pathway
Lung cancer
Time intervals
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