Identification of barriers to the early diagnosis and management of people with lung cancer in primary care and description of best practice solutions.

The Northern Cancer Network has received a three year District Health Board New Zealand research grant administered by the Health Research Council to:

i) Identify barriers to the early diagnosis of lung cancer in the Auckland and Lakes regions.
ii) Develop recommendations to improve healthcare services for people with lung cancer.

The project is a collaborative effort between the Northern Cancer Network, the Midland Cancer Network, Auckland District Health Board, Counties Manukau District Health Board, Lakes District Health Board (Lakes DHB), Procare Networks Auckland and Manukau, Total Healthcare Otara, Tamaki Primary Health Organisation (PHO), Rotorua Area Primary Health Service, Pinnacle Taupo, several Maori groups within the Auckland and Lakes region, the New Zealand Guidelines Group and the University of Auckland.

Please click here for details on the Research Team and Stakeholders and Background Information on lung cancer and the research project. An Inequalities Team (IT) will oversee the inequalities aspects of the project. An Expert Advisory Group will oversee the research and develop recommendations for service change based on the findings of the study. It is hoped that improved access to cancer care and earlier diagnosis will improve the health outcomes for people with lung cancer.

The project will assess the lung cancer journey from first presentation to the health care system until diagnosis. It will especially focus on the barriers to optimal care within primary care and at the interface between primary and secondary care. The project builds on previous research in the Northern region on the secondary care management of lung cancer.

It also complements activities by the Northern Cancer Network and Midland Cancer Network to improve public awareness of early cancer symptoms and encourage early presentation to health services.

The project involves several components:

i) Literature search

ii) Audit of the primary and secondary care clinical records for all (estimated 280) people with lung cancer diagnosed in 2008 in the participating PHOs and General Practitioner (GP) organisations.

iii) Interviews of people with suspected lung cancer who first present to secondary care via the emergency department at ADHB, CMDHB or Lakes DHB over a specified period in 2010. Interviews of people with suspected lung cancer who do not attend an appointment over a specified period in 2010. An estimated 50 interviews will be conducted. Focus groups of patients and their family/whanau will also be conducted to further explore issues raised in the interviews.

iv) Survey and focus groups of GPs (in the participating PHOs and GP organisations) to explore potential barriers to early lung cancer diagnosis from a GP perspective.

v) Practice survey of general practices (in the participating PHOs and GP organisations) to identify local service provision and processes of care.

vi) Successful services stocktake to identify successful services elsewhere, especially any innovative services by Maori or Pacific providers, in the relevant section of the lung cancer pathway.

vii) Development of a best practice assessment framework and key performance indicators to assess and monitor recommended service change.

viii) Development of recommendations for service change.

ix) Economic evaluation of the recommendation package.

As each component of the project is completed, the findings will be available on this website. Please click on the relevant component (above).

For any queries or further information regarding the research please contact the principal investigator, Dr Wendy Stevens (w.stevens@auckland.ac.nz)