gms | German Medical Science

Background: Lung cancer is the leading cause of cancer deaths in Australia. Late detection and extended delays in referral contribute to high mortality rates. Consequently, the Australian Government agency, Cancer Australia, sought to develop guidance for general practitioners about the early investigation and referral of lung cancer.

Objectives: To develop a guide for general practitioners on the effective investigation and referral of people who have or may have lung cancer.

Methods: An evidence-based guide was developed using the processes detailed in the ADAPTE framework for guideline adaptation (Version 2.0).

Results: A search of the literature identified 75 potentially relevant guidelines, of these 15 guidelines was assessed using the AGREE instrument and a shortlist of three international guidelines (UK, NZGG and USA) were selected to inform this guide. Recommendations in the guide focus on three key topics: the symptoms or combinations of symptoms that are likely to indicate lung cancer, the effectiveness of diagnostic and staging investigations in patients with suspected lung cancer and effective follow up of suspected lung cancer through referral pathways.

Discussion: Barriers to the early detection of lung cancer occur at the patient, practitioner and health system levels. While this guide targets general practitioners, a targeted implementation strategy is necessary to encourage uptake and use by health professionals and consumers.

Implications for guideline users: A new evidence-based guide has been crafted to assist general practitioners manage patients who have or may have lung cancer and to support early and rapid referral into the cancer care pathway.