Poster Presentation NSW State Cancer Conference 2023

Optimising Early Detection and Management of Lung Cancer: Empowering Pharmacists to Lead Lung Health Evaluation and Prioritisation (#269)

Simmie Chung 1 , Bandana Saini 1 , Irene Um 1
  1. University of Sydney, Sydney, NSW, Australia

BACKGROUND Lung cancer is the leading cause of cancer-related deaths, with a low 5-year survival rate of 20.5% in 2022. Early diagnosis is crucial for better outcomes.  Community pharmacists, often the first point of contact for respiratory presentations, could play a critical role in assessing symptoms and referring patients to GPs for further assessment. However, there has been no active involvement for pharmacists in lung cancer screening in international concerted efforts. Utilising pharmacists as a preliminary assessment and triage step could aid in early detection of lung cancer, ultimately leading to improved patient prognosis and quality of life.  

PURPOSE To scope the existing literature to determine the protocols utilised and evaluate the impact of pharmacists' involvement in lung cancer awareness, screening, or triage programs. 

METHOD A scoping review was performed to systematically explore the literature, map and summarise the evidence on the pharmacists’ role in the early detection of lung cancer. The review adhered to the methodological framework for scoping reviews outlined by Arksey and O'Malley. A comprehensive search strategy was developed in consultation with academic librarian. It was then applied to interrogate Medline (PubMed), Embase, CINAHL, and Scopus databases. Studies were included if they explored pharmacist interventions in information provision, screening for, or referral of patients at risk of lung cancer. Articles published in English between January 2000 to April 2023 were considered eligible for inclusion.

RESULTS Of 267 articles screened, only 5 studies met the inclusion criteria. These studies included 4 qualitative studies that were conducted with a range of stakeholders (eg community pharmacists n=30, GPs, nurses, respiratory consultants, radiologist, community service leads) and lung cancer patients to gather information via focus group interviews and questionnaires. One study investigated the feasibility of a community-based pharmacy referral service that involved 17 UK community pharmacies. In this study, pharmacists invited 12 patients, all consented and 11 were found at risk and referred for a chest x-ray, but no follow-up service was provided.  

CONCLUSION The barriers and facilitators for the implementation of such services, including the need for workforce capacity and training, well-publicised awareness campaigns, improved communication and referral pathways between pharmacists and other health professionals as well as remuneration, were highlighted by pharmacist participants. Whilst this review provides detailed insights into the role of pharmacists in lung health assessment, especially for early detection of lung cancer, it indicated that research on this topic is, as yet, scant.

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