Background
Lung cancer is the leading cause of cancer related deaths in the United States. The impact of treatment delay proves difficult to quantify, but increased time to treatment and subsequent progression can limit a patient’s chance for curative intent therapy. Reducing time to treatment aims to improve patient outcome and experience. This study aims to identify the median timeframes that occur in the diagnosis and treatment of lung cancer patients within a single Veteran Affair (VA) Medical Center.
Methods
A retrospective chart review was conducted on 123 new primary lung cancer cases detected by imaging between January 1, 2019 and December 31, 2022 within a single VA medical center. Exclusions were preexisting lung cancer or other malignancy. The following data was collected: time to PET scan, referrals, and treatment initiation. KruskalWallis test and Mann-Whitney U test was employed to assess differences in treatment times based on treatment modality and disease stage, respectively
Results
The median time from first abnormal image to PET scan was 26 days. The median time from initial abnormal scan to treatment was 91 days. Treatment initiation was significantly shorter in late-state disease (IV, extensive stage) at 57 days compared to early-stage disease (I-III, limited stage) at 98.5 days (p= 0.00008). There was a difference in the median time from abnormal scan to treatment initiation based on treatment modality: chemotherapy, radiation therapy, and surgical intervention occurred at 60 days, 86 days, and 98 days, respectively (p= 0.005).
Conclusions
At our institution, patients with latestage lung cancer initiate therapy significantly faster than those diagnosed with early-stage cancer. We feel this is largely due to complex, multidisciplinary coordination of early-stage disease, in contrast to those diagnosed at later stage disease who are treated in a palliative, systemic fashion. This study was instrumental at identifying key areas along the process that can be improved upon. Based on this data, changes will be implemented and studied in effort to shorten time to treatment.
