Table 3.

GP perspectives on nine symptoms potentially indicative of lung cancer

Symptom	Views of GPs
Tiredness	Non‐specific symptom. Very common in general practice
	Tiredness alone is “almost never of significance”
	Perceived to be an “early” symptom
	Other symptoms experienced more acutely by patients if combined with tiredness
	Other symptoms are viewed more seriously if combined with tiredness
Cough	High prevalence expected due to of COPD amongst many ex‐/smokers population group
	Patients often think it is normal for smokers to have a cough
	Cough may last for 4–6 weeks post‐viral chest infection
	Only chronic cough (≥6 weeks) in the absence of recent infection would concern GPs
Breathing changes	Breathlessness a “fairly ubiquitous” symptom
	Progressively worse breathlessness a good indicative symptom of lung cancer
	Usually a late symptom, patients with lung cancer rarely present with it as a first symptom
	Older/inactive patients are less aware of their breathlessness/consider it normal
Sweats	Patients rarely present with sweats alone
	Important symptom when combined with cough
	An important symptom only if sweating is “profuse”/“drenching”
Chest infections	“Red flag” symptom if patient recently experienced many infections that do not settle
	A late sign of lung cancer
Unintentional weight loss	Always seen as a “red flag” symptom if sudden and significant
	Seen as a late symptom – “usually too late for survival”
	Diagnosis difficult if experienced as only symptom, as indicative of any tumour type
Chest pain	Patients subsequently diagnosed with lung cancer rarely present with chest pain
	Perceived as a “very late” symptom
	Often musco‐skeletal in origin, subsequent to coughing
Voice changes	Most common with laryngeal cancer
	Patients rarely present with this symptom
	GPs would refer anyone with dysphonia
Haemoptysis	Always a “red flag” symptom
	Refer for CXR immediately
	Seen as a “very late” symptom
	Sometimes caused by coughing