ArticleActa oncologica (Stockholm, Sweden)2025
How do health literacy and chronic disease influence the diagnostic evaluation of patients with lung cancer symptoms?
Article in Acta oncologica (Stockholm, Sweden), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Diagnostic pathways for lung cancer patients in Denmark: General practice events, first referral and stage at diagnosis.Acta oncologica (Stockholm, Sweden) · 2026Article
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6 authors.
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Abstract
background and purposeSmoking status, health literacy challenges and chronic diseases may influence the diagnostic evaluation of patients presenting with lung cancer symptoms (LCSs) in general practice. This study aimed to (1) analyse associations between smoking status, health literacy, chronic disease and having completed diagnostic imaging amongst patients with LCSs in Danish general practice and (2) investigate how these factors interact in relation to the completion of diagnostic imaging, by examining effect modification and causal mediation. Patient/material and methods: In 2022, a random sample of 100,000 individuals aged ≥ 20 years from the Danish population was invited to participate in a survey about symptoms and healthcare seeking. This study included individuals aged ≥ 40 years who reported general practitioner (GP) contact with LCSs. Questionnaire data included health literacy, chronic disease and smoking status. Register data included socioeconomics, prescription drugs and diagnostic imaging. Descriptive statistics, multivariable logistic regression and causal mediation models were applied.
resultsOf the 2,252 patients who had contacted their GP with LCSs, 22% had completed diagnostic imaging. Formerly smoking increased odds of diagnostic imaging compared to never smoking, whereas current smoking had no influence. No associations or mediations were demonstrated between health literacy, chronic disease and diagnostic imaging. Effect modification was implied by varying impact of health literacy on diagnostic imaging depending on smoking status, yet the results were limited by power.
interpretationInitiatives targeting awareness of the risk of overlooking cancer symptoms amongst high-risk patients presenting in general practice may improve the chance of timely diagnosis of lung cancer.
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