Effect of Symptom-To-Treatment Interval on Prognosis in Lung Cancer

Annakkaya, Ali Nihat; Arbak, Peri; Balbay, Öner; Bilgin, Cahit; Erbaş, Mete; Bulut, İsmet

doi:10.1177/030089160709300111

Cited by 52 publications

(55 citation statements)

References 28 publications

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“…However, contrary to expectation, timely care was not associated with better prognosis in these patients. Although this result corroborates findings from previous studies, [35][36][37] it contradicts findings from 2 US studies. 38,39 The observed paradoxical results may be explained by selection bias, as symptomatic patients with advanced stage disease are more likely to receive prompt (timely) care, despite their poor prognosis to begin with.…”

Section: Discussionsupporting

confidence: 85%

Disparities in Lung Cancer Care and Outcomes among Elderly in a Medically Underserved State Population—A Cancer Registry-Linked Database Study

Nadpara

Madhavan

Tworek

2016

Population Health Management

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Despite availability of guidelines for lung cancer care, variations in lung cancer care among the elderly exist across the nation and are a cause for concern in rural and medically underserved areas. Therefore, the purpose of this study was to evaluate the patterns of lung cancer care and associated health outcomes among elderly residing in a rural and medically underserved area. The authors identified 1924 elderly lung cancer patients from the West Virginia Cancer Registry-Medicare linked database (2002)(2003)(2004)(2005)(2006)(2007) and categorized them by receipt of guideline-concordant (appropriate and timely) care using guidelines from the American College of Chest Physicians, British Thoracic Society, and the RAND Corporation. Hierarchical generalized logistic models were constructed to identify variables associated with receipt of guideline-concordant care. KaplanMeier analysis and log-rank test were used to compare 3-year survival outcomes. Multivariate Cox proportional hazards models were constructed to estimate lung cancer mortality risk associated with nonreceipt of guidelineconcordant care. Although guideline-concordant appropriate care was received by fewer than half of all patients (46.5%), of those receiving care, 78.7% received it in a timely manner. Delays in diagnosis and treatment varied significantly. Survival outcomes significantly improved with appropriate care (799 vs. 366 days; P £ 0.05), but did not improve with timely care. This study highlights the critical need to address disparities in receipt of guideline-concordant lung cancer care among the elderly residing in rural and medically underserved areas. Although lung cancer diagnostic and management services are covered under the Medicare program, underutilization of these services is a concern.

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Section: Discussionsupporting

confidence: 85%

Disparities in Lung Cancer Care and Outcomes among Elderly in a Medically Underserved State Population—A Cancer Registry-Linked Database Study

Nadpara

Madhavan

Tworek

2016

Population Health Management

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“…Two Scandinavian studies conducted revealed that the lag between the initial visit to the GP and diagnosis confirmation among patients with lung cancer was 88 and 97 days, respectively (20,21). While most studies found a delay relatively longer than what we have identified, a Turkish study reported that the average delay in a diagnosis for lung cancer was just 41 days (18). Because the countries that have been investigated are very distinct not only in their healthcare systems, but also very much in their cultural and local contexts, we believe further examination into their health service delivery and healthcare-seeking behavior is worthwhile.…”

Section: Discussionmentioning

confidence: 52%

Referral-free Health Care and Delay in Diagnosis for Lung Cancer Patients

Hsieh

Liu

et al. 2012

Japanese Journal of Clinical Oncology

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Objective: Lung cancer is not only one of the most prevalent cancers but is also a lethal disease with a very low 5-year survival rate. Delay in diagnosis further reduces the chance of early treatment and worsens patients' survival. The purpose of this study was to understand the delay in the diagnosis of lung cancer under the healthcare system in Taiwan, and to identify the factors associated with it. Methods: A total of 840 patients diagnosed with lung cancer who had completed or were undergoing cancer treatments were recruited from a medical center in central Taiwan from July 2007 to January 2011. Structured questionnaires were administered regarding demographic characteristics, factors associated with their time to diagnosis and the length of delay in days. Results: Mean age was 62.68 years with 52.16 days to diagnosis on average. Number of hospital visits before confirmation of diagnosis differed significantly with the level of healthcare institution initially visited (P , 0.001). Compared with patients who had three or more hospital visits, patients who only visited two and one hospital(s) had a significant 34.91-day (95% confidence interval: 16.29 -53.53) and 42.25-day (95% confidence interval: 20.76 -63.76) reduction in their time to diagnosis (P , 0.001). Conclusions: As the number of hospital visits increased, the delay in diagnosis also increased. It is vital to shorten the time to diagnosis for lung cancer patients by limiting the number of medical visits and educating the public to restrict excessive use of medical resources and strengthen their trust in medical professionals.

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“…This is despite clear advice in the British National Institute for Clinical Excellence (NICE) guidelines regarding chest x-ray referral 42 . The delay from first presentation to referral to a respiratory specialist has been reported to range from a mean of 34 days 38 to 73 days (range 0->175) 37,36,39,43,44 .…”

Section: Symptom Recognition and Reportingmentioning

confidence: 99%

Diagnosis of Lung Cancer — Improving Survival Rates

Athey

Tod²,

Suckling³

et al. 2010

European Oncology &Amp; Haematology

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647021Word Count (excluding references) = 2,250Key Words: Lung Cancer, Early Diagnosis, Screening, Social Marketing Abstract Lung cancer is a major global health burden with high incidence rates but poor long-term survival. Currently the majority of cases are diagnosed at an advanced stage when surgical resection is not feasible. Screening for lung cancer has been a major focus of research for the last 40 years. Despite this there is still a lack of evidence to promote its use outside of a clinical trial. More recently interest has focussed on promoting earlier recognition of symptomatic disease among both the general public and primary care physicians, in order to encourage more timely investigation and referral to secondary care. The hope is that this approach may increase the proportion of disease identified in the early stages, allowing more surgical resections and improved 5-year survival rates. This paper provides an overview of the current evidence base regarding early diagnosis of lung cancer and provides some examples of innovations to promote this. 2Background

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Effect of Symptom-To-Treatment Interval on Prognosis in Lung Cancer

Abstract: The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.

Cited by 52 publications

References 28 publications

Disparities in Lung Cancer Care and Outcomes among Elderly in a Medically Underserved State Population—A Cancer Registry-Linked Database Study

Disparities in Lung Cancer Care and Outcomes among Elderly in a Medically Underserved State Population—A Cancer Registry-Linked Database Study

Referral-free Health Care and Delay in Diagnosis for Lung Cancer Patients

Diagnosis of Lung Cancer — Improving Survival Rates

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