Timing in initiating lung cancer treatment after bronchoscopy in France: Study from medico-administrative database

Kudjawu, Y.; Châtellier, Gilles; Decool, E.; Maria, Florence de; Beltzer, Nathalie; Grémy, Isabelle; Meyer, Guy; Eilstein, Daniel

doi:10.1016/j.lungcan.2016.02.016

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…These data show that, from 2004 to 2013, the median and mean TTI for PBS in the United States were 22 days and 32 days, respectively. As a comparison, TTI for head and neck cancer in the United States was 26 days between 1998 and 2011 [ 9 ], while TTI for colon [ 16 ] and lung [ 17 ] cancer in France between 2009 and 2010 was 22 and 34 days, respectively. In the current study, Figure 3 delineates those factors that were attributed to increased or decreased TTI in PBS.…”

Section: Discussionmentioning

confidence: 99%

Adult Primary Bone Sarcoma and Time to Treatment Initiation: An Analysis of the National Cancer Database

Lawrenz

Curtis

Styron

et al. 2018

Sarcoma

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Objective The time to treatment interval (TTI), defined as the period from diagnosis to first definitive treatment, has very limited descriptions toward understanding delays in primary bone sarcoma (PBS) care. Our primary goal was to determine the national standard for time to treatment initiation (TTI) in PBS in adults and to identify characteristics associated with TTI variability. Methods An analysis of the National Cancer Database identified 15,083 adult patients with PBS diagnosed from 2004 to 2013. Kruskal–Wallis analysis identified differences between covariates regarding TTI and regression modeling identified covariates that independently influenced TTI. Results The median TTI was 22 days. Approximately 60% of patients were definitively treated in the same center where the index diagnosis was made. Increased TTI was correlated with a transition in care institution (incidence rate ratio (IRR) = 1.89; P < 0.001), being uninsured (IRR = 1.36; P < 0.001), primary tumor site in the pelvis (IRR = 1.26; P < 0.001), Medicaid insurance status (IRR = 1.22; P < 0.001), care at an academic center (IRR = 1.14; P < 0.001), non-white race (IRR = 1.12; P=0.002), and Medicare insurance status (IRR = 1.08; P=0.017). Decreased TTI was correlated with a diagnosis of chondrosarcoma (IRR = 0.85; P < 0.001), having surgery as the index treatment (IRR = 0.88; P < 0.001), a primary tumor site of the lower (IRR = 0.91; P=0.001) or upper extremity (IRR = 0.92; P=0.023), and stage II or stage III disease (IRR = 0.91; P=0.010). Conclusions TTI is associated with tumor, treatment, and socioeconomic and healthcare system characteristics. Transitions in care between institutions are responsible for the greatest increase in TTI. As TTI is more commonly used as a quality metric, physicians need to be aware of the causes for prolonged TTI, as we work to improve national delays in diagnosis and treatment initiation.

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Section: Discussionmentioning

confidence: 99%

Adult Primary Bone Sarcoma and Time to Treatment Initiation: An Analysis of the National Cancer Database

Lawrenz

Curtis

Styron

et al. 2018

Sarcoma

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“…A shorter delay was associated with a poorer prognosis due to an expedited diagnostic process in advanced patients [7][8][9], who may present with neurological symptoms, appetite loss, hemoptysis, or pain [16]. Patients with older age and multiple comorbidities [16,17] or who initially declined bronchoscopy or underwent numerous diagnostic procedures [8] had a longer delay to initiating treatment. Definitive surgical resection for early-stage lung cancer performed 38 days or more after diagnosis had significantly worse 5-year survival [18].…”

Section: Discussionmentioning

confidence: 99%

Impact of an Onsite Endobronchial Ultrasound Program on the Time to Treatment of Cancer in Veterans

et al. 2019

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Background: Endobronchial ultrasound (EBUS) is commonly employed in the diagnostic evaluation of pulmonary nodules and for mediastinal staging of lung cancer. We hypothesized that the establishment of an onsite EBUS program would decrease the time to the diagnosis and treatment of detected malignancy in veterans seen in a dedicated pulmonary nodule clinic. Methods:We conducted a retrospective chart review of patients seen at the Baltimore Veterans Affairs Medical Center (BVAMC) pulmonary nodule clinic and required diagnostic evaluation. One hundred and fifty consecutive patients before and after implementation of an onsite EBUS program were screened.Results: Forty-nine patients from the pre-intervention group and 41 patients from the post-intervention group underwent diagnostic evaluation and were included in study analyses. There was no significant difference in the median number of days between CT chest and initial visit to the BVAMC Lung Mass Clinic (22 vs. 14 days, P = 0.06), CT chest to diagnostic procedure (47.5 vs. 37 days, P = 0.33), and CT chest to initial treatment of detected malignancy (103 vs. 88 days, P = 0.15). There was no significant difference in the lung cancer stages or 1-year mortality between groups. A total of 76 barriers to care were identified among the 90 patients. Conclusions:There was a trend towards improving the time from the initial CT chest to the treatment of cancer with onsite availability of EBUS. More efforts need to be done to decrease the modifiable barriers to treatment to improve the overall lung cancer care for veterans.

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“…Consequently, the construction of algorithms to identify clinical data requires a multidisciplinary approach involving epidemiologists, statisticians, medical information department physicians, clinicians or national health insurance personnel. To date, several studies have been published in the field of cancer using such algorithms on SNDS [ 17 – 22 , 14 , 8 , 23 , 24 ] [ 25 ]. For example, French Health Insurance has developed a disease and expenditure mapping tool, using such algorithms, which was previously used to describe the human and economic burden of cancer in France in 2014 [ 11 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Cancer care and public health policy evaluations in France: Usefulness of the national cancer cohort

et al. 2018

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BackgroundIn the context of the national Cancer Plans of France that have changed the healthcare landscape, it has become necessary to better document and assess the related actions, and to promote research and understanding. The national cancer cohort, an exhaustive population-based cohort, was set up on the basis of the National Health Data System (SNDS) by the French National Cancer Institute.ObjectivesThe aim is to describe the French national cancer cohort.MethodsAll people living in France (67 million population) with universal insurance coverage and diagnosed, treated or followed up for a cancer, such as survivors, are included and will be followed up for 25 years. It contains all healthcare consumptions and reimbursements (i.e. hospitalization, outpatient care, medication…) since 2010. Every year, around 650 000 new cases are included.ResultsFrom 2010 to 2015, 6.2 million subjects have been included. Most subjects were entered in 2010, in 2015 it concerned 0.6 million. In 2015, the median age was 65 [54–76]; 51% were women. The primary cancer organ could be attributed with certitude to 87% of the people. The most frequent locations were skin (16%), breast (15%), prostate (12%), colon-rectum (11%) and lung (9%). In 2015, 40% of included subjects underwent surgery for cancer, 16% chemotherapy at hospital and 11% at least one session of radiotherapy.ConclusionBased on SNDS, the cancer cohort has been designed to study cancer care use in the short-, medium- and long-term, and evaluate healthcare and public health policies.

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Timing in initiating lung cancer treatment after bronchoscopy in France: Study from medico-administrative database

Cited by 7 publications

References 15 publications

Adult Primary Bone Sarcoma and Time to Treatment Initiation: An Analysis of the National Cancer Database

Adult Primary Bone Sarcoma and Time to Treatment Initiation: An Analysis of the National Cancer Database

Impact of an Onsite Endobronchial Ultrasound Program on the Time to Treatment of Cancer in Veterans

Cancer care and public health policy evaluations in France: Usefulness of the national cancer cohort

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