For the project “Identification of Barriers to the Early Diagnosis of People with Lung Cancer within Primary Care and Description of Best Practice Solutions (October, 2009)”

The first phase of the project ‘Identification of Barriers to the Early Diagnosis and Management of People with Lung Cancer and Description of Best Practice Solutions’ involved a comprehensive search of the national and international literature to identify the main barriers to optimal care from initial presentation until diagnosis for people with suspected lung cancer; recommended best practice solutions to minimise these barriers, and the evidence-base for these recommendations. The search was performed by the principal investigator using the methods detailed below.

Aims and Scope of the Literature Review

The main aim of the literature review was to identify recommended best practice service delivery relating to that section of the lung cancer patient pathway from initial presentation to health services with symptoms, signs or an incidental finding suggestive of cancer, until the first specialist appointment (FSA), and the evidence underlying such recommendations. The section of the pathway immediately following the FSA leading up to diagnosis, although not the main focus of the study, was also included. However the pathway prior to presentation and that following diagnosis were not included, as these were beyond the scope of the current project.

In addition to identifying opportunities for service change, the literature review aimed to provide context by identifying other research in the field, and to provide a theoretical framework for the assessment of best practice by identifying dimensions of quality care. It also sought to inform subsequent phases of the project, including the development of question domains for the interviews, surveys and focus groups.

As the scope of this literature review was broad, an overview of the relevant literature rather than a formal systematic literature review was performed. The literature review focused on the clinical pathway rather than on the clinical management for people with lung cancer and therefore it did not cover prevention, screening or treatment.