Abstract / Summary
Early detection of lung cancer is essential to reduce mortality. This study assessed the competencies (knowledge, clinical practices, and attitudes) of family physicians for such detection in Guantánamo, Cuba, a region with an atypical epidemiological profile (93% of cases in non-smokers; 67.5% linked to occupational exposure). A mixed-methods study with methodological triangulation. An adapted validated questionnaire (pilot subscales α = 0.82–0.91; overall α = 0.91) was administered to 279 family physicians, 532 clinical records were reviewed, two focus groups with 14 physicians and eleven semi-structured interviews with administrators were conducted, and an observation guide was applied. Data were analysed using descriptive statistics and thematic analysis. A total of 92.7% of participants showed favourable attitudes toward early detection. However, only 47.3% knew the clinical guidelines and 34.7% correctly identified occupational risk factors. A total of 92% of clinical records were outdated and systematic follow-up was evident in only 3.8% of cases. Triangulation revealed substantial agreement across data sources (kappa > 0.75). There is a marked dissociation between favourable attitudes and adequate clinical practice. These findings support the implementation of cancer education strategies in primary health care.