An Integrative Review to Examine the Care Pathways and Support Available for Individuals Diagnosed with Lung Cancer Who Have Never Smoked

As the proportion of people diagnosed with lung cancer who have never smoked rises, it is important to understand how their experiences differ from those of smokers. A better understanding of their experiences, views, and informational and supportive care needs is essential to ensuring an optimised patient-centred care pathway leading to improvements in patient satisfaction, quality of life, and treatment outcomes. This integrative review of the international literature identified 5866 articles by searching four academic databases, the grey literature, and hand-searching the reference lists of relevant systematic reviews. After screening, ten studies were selected for inclusion in the review. Thematic analysis identified five themes that spoke to the experiences of never smokers with lung cancer: stigma, awareness, diagnosis, the emotional response, and support. Stigma pervades, with potentially significant psychological and social consequences, negatively affecting patients emotionally and potentially delaying their diagnosis. Increasing awareness amongst healthcare professionals and the general public has the potential to reduce stigma and encourage earlier diagnosis. Support specifically tailored for never smokers with lung cancer can improve individuals' experiences of care. The experiences of never smokers with lung cancer are unique, and more research is required to better tailor support and guidance for this cohort.