Exploring the integration of primary care pharmacists in early lung cancer case-finding and referral pathways: a scoping review.

OBJECTIVES: Global lung cancer cases will exceed 4.6 million by 2050, with most diagnosed at advanced stages. As early diagnosis improves prognosis, making symptom recognition, risk assessment and timely referral important. Pharmacists, as accessible professionals, can support case-finding through symptom-enquiry, risk-assessment, brief-intervention, and referral. Literature on lung cancer case-finding initiatives led by community pharmacists is limited. This scoping review aims to examine the integration of primary care pharmacists in early lung cancer case-finding and referral pathways, including the clinical and procedural characteristics and reported outcomes of such models. METHODS: Studies involving pharmacists in lung cancer case-finding activities in primary-care were identified. CINAHL, Embase, MEDLINE, Scopus (January 2000-November 2025) were searched using strategy including community pharmacy initiatives and stakeholder perspectives. Study characteristics, pharmacist roles, outcomes, and contextual enablers/barriers were extracted, tabulated, synthesised, and appraised using COREQ(qualitative) or MMAT(mixed-methods). KEY FINDINGS: Of 520 records screened (469 database; 51 citation-chaining), seven met inclusion criteria. A feasibility-study trialled pharmacist-led, lung cancer case-finding with direct referral of at-risk patients to a tertiary chest X-ray clinic. Six qualitative studies explored a range of stakeholder perspectives. Pharmacists reported willingness to support symptom-recognition and referral, while other stakeholders viewed pharmacies as accessible case-finding sites. Enablers to pharmacist's role include accessibility and trusted patient-pharmacist relationships. Barriers included reliance on general-practitioner-mediated referral pathways, limited training, unclear role definition and need for structured integration in pharmacy operations. CONCLUSION: This review highlights that pharmacists can identify red-flag symptoms and facilitate referral in lung cancer case-finding, but training and system barriers necessitate structured, co-designed referral tools, targeted education and stronger system integration.