{
  "abstract": "Background The United Kingdom and Australia are amongst the countries with the highest rate of mesothelioma, a rare cancer due to exposure to asbestos. There is a very low survival rate partly due to delayed diagnosis, and deaths are on the rise. There were 2,446 mesothelioma deaths in Great Britain in 2020, an increase of 6% compared with 2019. While in Australia, there were 701 deaths in 2020, an 3% increase. The aim of the study is to explore the Australian patients’ journey from symptoms to diagnosis, to identify key factors that may have contributed to a timely (or delayed) diagnosis. Key learning points relevant to UK practice, will be presented.Methods Patients with confirmed pleural mesothelioma (PM) diagnosis were invited to take part in an in-depth, semi-structured interview about their pathway to diagnosis. Participants were purposively recruited from a research institute in Australia. A total of ten participants took part in the study.‘The Model of Pathway to Treatment’ (MPT) highlights four time-intervals (Appraisal; Help-seeking; Diagnostic; and Pre-treatment), where patients can experience facilitators or delays to diagnosis and treatment plans. MPT was used to develop the interview topic guide and provided the initial coding frame for interview transcriptions. Common themes were then identified within each MPT interval.Results Our findings identified barriers and facilitators within every interval along the PM patients’ journey to diagnosis. Within the ‘Appraisal’ interval, workplace medicals and patient’s knowledge of asbestos exposure, facilitated prompt onward referral. Similarly, healthcare professionals (HCPs) knowledge of mesothelioma, and prompt referrals for medical investigations were facilitators to diagnosis. Facilitators to treatment planning was patients‘ informed decision making and private health cover. Attributing symptoms to advancing age, or underlying or persistent conditions, were reoccurring barriers in ‘appraisal’, ‘help seeking’ and ‘diagnostic’ intervals. A potential delay to treatment plans, was seen in patients with a preference for a specific oncologist or hospital.Conclusion Overall, Australian patients and HCPs had good knowledge of the dangers of asbestos and related cancers, this may be in part due to awareness campaigns. The UK should aim to produce media campaigns to improve patient and HCP health literacy and raise awareness of mesothelioma. Patients who have workplace medicals or health insurance, or those who have funds to pay for medical treatment, may receive more timely diagnosis and treatment. However, this could worsen health inequalities in the UK, where privatised services are available options.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Health and Life Sciences, De Montfort University, Leicester, UK"
      ],
      "name": "Dawn Coleby"
    },
    {
      "affiliations": [
        "Faculty of Health and Life Sciences, De Montfort University, Leicester, UK"
      ],
      "name": "Osaretin Oviasu"
    },
    {
      "affiliations": [
        "Faculty of Health and Life Sciences, De Montfort University, Leicester, UK"
      ],
      "name": "Wendy Padley"
    },
    {
      "affiliations": [
        "Faculty of Health and Life Sciences, De Montfort University, Leicester, UK"
      ],
      "name": "Kathryn Hinsliff-Smith"
    },
    {
      "affiliations": [
        "Asbestos and Dust Diseases Research Institute (ADDRI), Concord, Australia",
        "Faculty of Medicine and Health, University of Sydney, Sydney, Australia"
      ],
      "name": "Pamela Logan"
    },
    {
      "affiliations": [
        "Asbestos and Dust Diseases Research Institute (ADDRI), Concord, Australia",
        "Faculty of Medicine and Health, University of Sydney, Sydney, Australia"
      ],
      "name": "Jennifer Coles"
    },
    {
      "affiliations": [
        "Asbestos and Dust Diseases Research Institute (ADDRI), Concord, Australia",
        "Faculty of Medicine and Health, University of Sydney, Sydney, Australia"
      ],
      "name": "Carmel Oostveen"
    },
    {
      "affiliations": [
        "Asbestos and Dust Diseases Research Institute (ADDRI), Concord, Australia",
        "Faculty of Medicine and Health, University of Sydney, Sydney, Australia"
      ],
      "name": "Anthony Linton"
    }
  ],
  "title": "P80 What can we learn from Australian patients‘ journey to mesothelioma diagnosis? A qualitative study",
  "uid": "5fd26363-4cac-5f44-bbdd-116d7107829f"
}