The following could contribute to reducing diagnostic delay: There should be appropriate educational tools developed and disseminated that highlight the signs and symptoms of lung cancer for clinicians and for patients Clinicians should have a high index of suspicion with a low threshold for investigation of suspected lung cancer in ordering chest x-ray scans and referring patients to lung cancer specialists or diagnostic assessment programs Decision-support tools should be readily available to assist cliniciansClinicians should include as much information as possible in their referral letters and should ask patients to help retrieve electronic copies of their imaging tests to bring to specialist appointments Counseling of patients should occur to address common fears and concerns Public health and other health agencies should work with local community leaders to address challenges, such as lower levels of education or demographic discrepancies in communities with high rates of lung cancer or known delays in lung cancer diagnosis

Data from the National Institute for Health and Care Excellence,² the New Zealand Guidelines Group,⁶ Olsson et al,⁷ Singh et al,⁹ and Spiro et al.¹⁰