Background: Early detection of cancer has been a longstanding goal. It has been postulated that delay from diagnosis to treatment may impact on treatment outcomes. For lung cancer, screening is still only in its rudimentary stages; current literature on the topic has had mixed findings. This study was undertaken to quantify the timelines in the diagnosis and management of lung cancer in South West Sydney and to compare these timelines to best practice guidelines.
Methods: A retrospective audit of all newly diagnosed primary lung cancer patients treated at the Liverpool/Macarthur Cancer Therapy Centres from 1/1/2009-31/12/2009 was carried out. Patient demographics, dates of referrals, dates of consultation and treatment were retrieved from the oncology database of the Centre. Patients included were those that received radical or palliative radiotherapy and chemotherapy or supportive care; patients treated only surgically were excluded due to missing information.
Results: A total of 228 patients were identified; 73% of patients had Non-Small Cell Lung Cancer (NSCLC) and 19% had Small Cell Lung Cancer (SCLC). The average duration from the first diagnostic procedure to treatment was 54 days (range 1-520days); duration varied significantly (p<0.05) according to the histology, stage, age and choice of first treatment. Patients who were referred to an oncologist prior to a tissue diagnosis being obtained were more likely to receive timely care (p=0.084). For 34%-50% of patients, the average time interval from referral to treatment commencement complied with the guidelines (British Thoracic Society) recommendations.
Conclusion: Heterogeneity in the pathway from diagnosis to treatment in lung cancer makes examining intervals difficult to compare. This audit of the selected lunc cancer population allows future comparisons of the timelines to explore the reasons behind the delay, to ensure the intervals examined do not increase and unnecessary causes of delays be rectified. One possible method of reducing delay could be through hastier referral of patients highly suspicious of lung cancer from respiratory physicians to oncologists.