Delays in the diagnosis of lung cancer Journal of Thoracic Disease, 08/02/2011

Ellis PM et al. – Lung cancer patients experience substantial delays from development of symptoms to first initiating treatment. There is a need to promote awareness of lung cancer symptoms and develop and evaluate rapid assessment clinics for patients with suspected lung cancers.

• Prospective cohort of patients referred with newly diagnosed lung cancer
• Surveyed over 3 month period to assess delays in diagnosis
• Patients reported when they first experienced symptoms, saw their doctor, what tests were done, when they saw a specialist and when they started treatment
• Descriptive statistics used to summarize different time intervals

• 56 of 73 patients consented (RR 77%)
• 52 patients (30M, 22F) were interviewed (2 died before being interviewed and 2 could not be contacted)
• The mean age was 68yrs
• Stage distribution was as follows (IB/IIA 10%, stage IIIA 20%, IIIB/IV 70%)
• Patients waited median of 21 days (iqr 7-51d) before seeing a doctor and further 22d (iqr 0-38d) to complete any investigations
• Median time from presentation to specialist referral was 27d (iqr 12-49d) and further 23.5d (iqr 10-56d) to complete investigations
• Median wait to start treatment once patients were seen at cancer centre was 10d (iqr 2-28d)
• Overall time from development of first symptoms to starting treatment 138d (iqr 79-175d)