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Delays in diagnosis and initiating treatment for patients with lung cancer.

6102 Background: Many patients with lung cancer report delays in the diagnosis of their disease. This situation may contribute to advanced stage at diagnosis and poor long term survival. This study explores the delays experienced by patients referred to a regional cancer centre with lung cancer.


METHODS
A prospective cohort of patients referred to a regional cancer centre with newly diagnosed lung cancer were surveyed over a 3 month period. Surgically resected patients were not included as they were treated at another site. Patients were asked when they first experienced symptoms, when they saw their doctor, what tests were done, when they saw a specialist and when they started treatment. A medical record review was employed to validate the data patients provided. Descriptive statistics were used to summarize the different time intervals.


RESULTS
56 of 73 patients consented (RR 77%). However, only 52 patients (30M, 22F) were interviewed as two expired before being interviewed and two could not be contacted. The mean age was 68 yrs. Stage distribution was as follows: IB/IIA 10%, IIIA 20%, IIIB/IV 70%. The initial treatment was as follows: 10% of patients supportive care alone, 19% chemotherapy, 44% radiation and 27% had combined chemoradiation. Patients waited a median of 21 days (IQR 7-51d) before seeing a doctor and a further 22d (IQR 0-38d) to complete any investigations. The median time from presentation to specialist referral was 27d (IQR 12-49d) and a further 63d (IQR 44-102d) to complete investigations. The median wait time to start treatment once patients were seen at the cancer centre was 10d (IRQ 2-28d). The overall time from development of first symptoms to starting treatment was 139d (IQR 100-174d).


CONCLUSIONS
Lung cancer patients experience substantial delays from development of symptoms to first initiating treatment. There is a need to develop and evaluate rapid assessment clinics for patients with suspected lung cancers. No significant financial relationships to disclose.