Evidence-practice gaps in lung cancer

Eur J Cancer Care (Engl). 2016 Oct 13. doi: 10.1111/ecc.12588. [Epub ahead of print]

Evidence-practice gaps in lung cancer: A scoping review.

Rankin NM1, McGregor D2,3, Stone E2,4, Butow PN2,5,6, Young JM2,7,8, White K2,9, Shaw T2,3.

Author information

• 1Sydney Catalyst Translational Cancer Research Center, University of Sydney, Camperdown, NSW, Australia. nicole.rankin@ctc.usyd.edu.au.
• 2Sydney Catalyst Translational Cancer Research Center, University of Sydney, Camperdown, NSW, Australia.
• 3Research in Implementation Science and eHealth (RISe), Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.
• 4Department of Thoracic Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia.
• 5Psycho-Oncology Co-operative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia.
• 6Centre for Medical Psychology & Evidence-based Decision-Making, University of Sydney, Sydney, NSW, Australia.
• 7Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW, Australia.
• 8School of Public Health, University of Sydney, Sydney, NSW, Australia.
• 9Cancer Nursing Research Unit, University of Sydney, Sydney, NSW, Australia.

Abstract

Lung cancer is a significant international health problem. Aligning clinical practice with evidence-based guideline recommendations has the potential to improve patient outcomes. This scoping review describes evidence-practice gaps across the diagnostic and management care pathway for lung cancer. We conducted searches of online databases Medline, PsychInfo, Cinahl and the Cochrane Library to identify studies published between 2008 and 2012. Of 614 articles screened, 65 met inclusion criteria. We identified seven evidence-practice gaps: (1) delays in timely diagnosis and referral; (2) curative and (3) palliative treatments are under-utilised; (4) older age and co-morbidities influence the use of treatments; (5) the benefits of multidisciplinary team review are not available to all lung cancer patients; (6) psychosocial needs are unmet; and (7) early referral to palliative care services is under-utilised. The scoping review highlighted three key messages: (1) there are significant challenges in the timely diagnosis and referral of lung cancer; (2) curative and palliative treatments, psychosocial support and palliative care are under-utilised in lung cancer management; and (3) variations in treatment utilisation appear to be associated with non-disease factors such as patient characteristics, provider practices and the organisation of health care services. Future research should focus on designing interventions to overcome variations in care.