LUSH - LUng Symptom awareness and Health

Principal / Lead investigator
Type of study

Qualitative study


In the UK lung cancer survival is poor, particularly in poorer communities. One reason is that people may put off going to their doctor with a symptom. This means they are more likely to be diagnosed with lung cancer at a late stage.

People who are at high risk of lung cancer - smokers, living in poorer communities, who have existing lung disease - are more likely to put off going to their doctor with a symptom. Therefore, we need to think of better ways to increase lung cancer awareness in high risk groups, and encourage them to go to their doctor quickly with symptoms.

We interviewed about 40 people who live in poorer areas of South Wales, Liverpool and North-east Scotland. We will ask GPs to help us find people to interview who are over the age of 40, are current or ex-smokers, and have serious lung disease. The interviews involved asking questions about their perceptions and beliefs about lung cancer symptoms.

We then held four focus groups to find out what people think about a community based lung cancer intervention: if it is something they could see fitting in with their community, where the intervention could take place, and whether they think people would go to it. Two groups were with members of the public over age 40, who are current or ex-smokers and who live in poorer communities. The other two groups were with healthcare professionals and community workers in these areas.

This study was novel in engaging a high-risk population to gain an in-depth understanding of the broader contextual influences on lung cancer symptom presentation. We found that perceived lack of health service entitlement and complex lives facilitated avoidance of recognising and presenting with lung cancer symptoms. Community-based interventions have the potential to empower disadvantaged populations to seek medical help for lung symptoms.

The results will be used to develop a community group based intervention aimed at increasing lung symptom awareness and encouraging people to go to their doctor early if they have a symptom.

Lay involvement

The LUSH study team included two PPI members who were recruited via the Health and Care Research Wales Involving People Networkand the other via the Cwm Taf Hub.

Who is the study sponsor?

Cardiff University

Does the study involve commercial partnership activity?


UKCRN portfolio number (if relevant)



Cancer Research UK

Total grant value


Start date


End date


How could this research potentially benefit patients?

Earlier diagnosis of lung cancer can improve survival. This study aims to provide insight into why people may prolong going to the doctor with a symptom of lung cancer and develop an intervention to prompt symptomatic presentation and promote earlier diagnosis to improve survival outcomes. 

Further information

To follow

Outputs generated (Reports / Publications)

McCutchan G, Hiscock J, Hood K, et al. Engaging high-risk groups in early lung cancer diagnosis: a qualitative study of symptom presentation and intervention preferences among the UK’s most deprived communities. BMJ Open 2019;9:e025902. doi: 10.1136/bmjopen-2018-025902

Smits SE, McCutchan G, Hanson JA, Brain K. Attitudes towards lung cancer screening in a population sample. 2018. Attitudes towards lung cancer screening in a population sample. Health Expectations 21 (6), pp. 1150-1158. 10.1111/hex.12819


To follow