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Lookup NU author(s): Anmol Sanghrajka, Professor Linda SharpORCiD, Professor Gill Rowlands
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025 The Authors.Objectives Lung cancer has a social gradient in survival and mortality. This review aimed to identify and synthesise qualitative evidence evaluating the role of low socio-economic status on the factors and experiences that lead to delays in lung cancer diagnosis in high-income countries. Study Design A qualitative systematic review. Methods This review identified and synthesised published qualitative evidence evaluating the role of low socio-economic status on factors affecting lung cancer diagnosis in high-income countries. MEDLINE, EMBASE, PsycINFO, CINAHL, and SCOPUS were searched from inception to 21/04/2023 to identify relevant qualitative studies including socio-economically disadvantaged individuals at high risk of, or with, lung cancer (or their family members); or healthcare professionals managing these groups. No language restrictions were applied. Study quality was assessed using the CASP Qualitative Checklist. Iterative thematic analysis was undertaken to create themes and concepts. Results The 12 eligible studies assessed multiple perspectives including lung cancer patients, those at high-risk of lung cancer, and healthcare professionals. Synthesis resulted in nine themes: knowledge, health beliefs and behaviours, psychological barriers, competing priorities, social influences, societal and community barriers, public health messages, structural barriers to help-seeking, and structural barriers to a formal diagnosis. Within these themes, there were 20 concepts, some of which fell into multiple themes. Emotional delays, lung cancer awareness, and excusing symptoms were the most commonly recurring concepts. Conclusions This review identified multiple barriers that should be addressed to reduce lung cancer inequalities. This information can be used to inform future public health policies and interventions.
Author(s): Sanghrajka A, Sharp L, Rowlands G
Publication type: Review
Publication status: Published
Journal: Public Health
Year: 2025
Volume: 249
Online publication date: 28/10/2025
Acceptance date: 23/09/2025
ISSN (print): 0033-3506
ISSN (electronic): 1476-5616
Publisher: Elsevier B.V.
URL: https://doi.org/10.1016/j.puhe.2025.105975
DOI: 10.1016/j.puhe.2025.105975
PubMed id: 41161218
