Aim
Prompt diagnosis and treatment of lung cancer have been shown to improve patient outcomes. This study explores the timeliness of care for lung cancer patients at Peninsula Health in Melbourne compared to the optimal care pathway.
Method
In this retrospective study, patients with new diagnosis of primary non-small cell (NSCLC) and small cell (SCLC) lung cancer in 2018 and 2019 were identified from multidisciplinary meeting and Victorian Lung Cancer registry database. Five key time intervals between first abnormal imaging to treatment for lung cancer were investigated. Factors associated with delays in each interval were analysed using multivariate analysis.
Results
Total of 181 patients were included which majority of them had NSCLC (87%). Initial referral was made within 7 days of the first abnormal imaging in 79% of the patients and majority (81%) were seen by relevant specialists within 14 days of the referral. However, only 28% received treatment within 6 weeks of the first referral. Most delays occurred between diagnosis and treatment, where 50% were diagnosed within 28 days of referral, and only 13% were treated within 14 days from diagnosis. Patients with NSCLC had significantly longer referral to treatment delays (65.5 days) compared to SCLC (27 days) (p<0.0001). Having Stage I & II NSCLC and requiring PET scan were also associated with longer treatment delays (88 days) compared to Stage III & IV NSCLC (57.5 days). Surgical treatment was associated with the longest median wait times for both diagnosis (40.5 days) and treatment (84.5 days), amongst all treatment modalities. Complex patients who required multiple biopsies and treatment planning had substantial delays for diagnosis and treatment.
Conclusion
This study reveals areas of delays in the diagnosis and treatment of lung cancer patients at Peninsula Health and provides valuable information for quality improvement in cancer pathway at the health service.