Health Literacy and Healthcare Seeking with Lung Cancer Symptoms among Individuals with Different Smoking Statuses: A Population-Based Study

Abstract

Objective. To estimate proportions of contacts to the general practitioner (GP) among people with specific and nonspecific lung cancer symptoms, respectively, in the Danish general population and to analyse the associations between health literacy and these contacts based on smoking status. Methods. A total of 67,280 randomly selected individuals aged ≥40 years were invited to a survey concerning symptoms and healthcare seeking. This study included lung cancer symptoms, GP contacts, smoking status, four aspects of health literacy, and socioeconomics. Descriptive statistics and multivariable logistic regression models were applied. Results. Of 22,055 respondents, 23% reported at least one specific lung cancer symptom, while 47% reported at least one nonspecific symptom. GP contacts ranged from 30% (tiredness) to 60% (shortness of breath). Individuals who currently smoke had lower odds of GP contacts. The health literacy aspect “Feeling understood and supported” increased the likelihood of GP contact, while “Having sufficient information” decreased the likelihood. Smoking status did not modify these associations. Conclusion. Efforts targeting individuals at risk of postponing healthcare seeking with lung cancer symptoms are needed. This study highlights aspects of health literacy that may be addressed in interventions increasing both individuals and community-based health literacy responsiveness and enhanced chances of timely healthcare seeking.