The Patient Experience of Pathways to Lung Cancer Diagnosis in Primary Care: a Mixed Methods Investigation of Factors Influencing Timeliness of Diagnosis

• Mixed-methods analysis revealed how communication, health literacy, and system navigation shape delays in the lung cancer diagnostic pathway. • General practitioner (GP) responsiveness and clinical suspicion, especially for non-smokers and those with comorbidities, were key determinants of timely investigation. • Patients endorsed focus on health literacy, including symptom-based assessment and greater self-advocacy support. • Findings identify opportunities to streamline diagnostic processes through enhanced GP education, health literacy, targeted patient self-advocacy work, and practical patient-clinician communication tools.