A Multidisciplinary Lung Cancer Program: Does It Reduce Delay Between Diagnosis and Treatment?

Lung. 2020 Dec;198(6):967-972. doi: 10.1007/s00408-020-00404-8. Epub 2020 Nov 7.

Abstract

Introduction: Lung cancer is the leading cause of cancer death in the USA, claiming more than 140,000 deaths annually. Delays in diagnosis and treatment can lead to missed opportunities for both curative and life prolonging therapies. This study aimed to evaluate duration of time to diagnosis and first treatment, as well as investigate reasons for delays in care.

Methods: This retrospective study included all lung cancer cases diagnosed by Stony Brook's Lung Cancer Evaluation Center (LCEC) between 2013 and 2019. Demographic, radiologic, pathologic and clinical variables were investigated, including cancer staging, histology, and medical and family histories. Evaluations included the determination of median time from initial encounter to diagnosis, median time from diagnosis to start of treatment and an exploration of the factors that influence possible causes for delays in care.

Results: The LCEC's comprehensive multidisciplinary lung nodule program yielded a median length of time from CT to PET of 11 days, PET to procedure of 13 days, procedure to treatment consult of 9 days, and from consult to treatment of 9 days. LCEC patients experienced an overall median of 44 days from initial presentation to first treatment compared to the national ideal of 62 days, thereby representing a 29% reduction in time from first CT to onset of treatment.

Conclusion: Delays in lung cancer diagnosis and treatment can negatively impact patient morbidity and mortality. This study suggests that a coordinated multidisciplinary lung cancer program may reduce delays in care, thereby improving patient outcomes.

Keywords: Barriers to care; Delay in care; Diagnosis; Lung cancer; Multidisciplinary care.

MeSH terms

  • Aged
  • Carcinoma / diagnosis*
  • Carcinoma / therapy*
  • Delayed Diagnosis / prevention & control*
  • Female
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Referral and Consultation
  • Retrospective Studies
  • Time Factors
  • Time-to-Treatment*
  • Tomography, X-Ray Computed