Abstract
Background It is unclear whether delays in care affect prognosis of patients with lung cancer. The primary objective of this study was to describe the care pathway of patients diagnosed with lung cancer in a French region. Secondary objectives were to identify markers associated with 1) time from imaging to treatment, and 2) with one-year survival.
Methods In a retrospective cohort study, clinical data from multidisciplinary team meetings (MTM) for all incident lung cancer cases discussed in 2018 in one French region were matched with medico-administrative data from the National Health Insurance Database. Care pathway time intervals were estimated for small cell lung cancer (SCLC), resected non-small cell lung cancer (NSCLC) and unresected NSCLC. Factors associated with delay in the care pathway were identified using linear regression; 1-year survival was analysed using Cox modelling.
Results A total of 685 patients were included. Median time between imaging and treatment was 49 days (q1-q3: 33–73), and was lower in cases of metastatic disease, SCLC, and private care. At one year, 48% had died (resected NSCLC 12%). In unresected NSCLC, time from diagnostic imaging to first treatment <49 days was associated with a higher risk of death. Time intervals were similar in patients with squamous cell carcinoma versus adenocarcinoma or undifferentiated carcinoma.
Discussion Time intervals in the care pathways of lung cancer were similar to previous reports, confirming the robustness of retrospective databases. In unresectable NSCLC, rapid care was not associated with better survival.
Footnotes
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- Received March 30, 2022.
- Accepted August 30, 2022.
- Copyright ©The authors 2022
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