AIMS AND BACKGROUND: Several countries have introduced programs for rapid diagnosis and treatment of cancer, but their impact on hospital care delay and tumor stage is not clear. We assessed the impact of a rapid diagnosis and treatment program (RDTP) for lung cancer on the diagnosis-to-treatment interval (DTI) and tumor stage. METHODS AND STUDY DESIGN: We performed a quasi-experimental study in an intervention group of 191 patients with lung cancer attended through the RDTP circuit and a comparison group of 171 patients attended through the routine hospital circuit. Groups were matched for age and patterns of presentation. Multivariate analysis adjusting for different factors was performed. RESULTS: The median DTI was 36 days for the RDTP group and 45 days for the comparison group (P = 0.021). More patients in the RDTP group had advanced stage illness (III-IV) than in the comparison group (P = 0.032). In the multivariate analysis, none of these associations was statistically significant. Regardless of the type of circuit, a DTI <30 days was associated with disseminated disease (OR 3.28, P = 0.003). CONCLUSIONS: In this study, the RDTP circuit failed to reduce DTI and influence stage. Our results suggest tumor stage is the main determinant of both DTI and disease outcome.
AIMS AND BACKGROUND: Several countries have introduced programs for rapid diagnosis and treatment of cancer, but their impact on hospital care delay and tumor stage is not clear. We assessed the impact of a rapid diagnosis and treatment program (RDTP) for lung cancer on the diagnosis-to-treatment interval (DTI) and tumor stage. METHODS AND STUDY DESIGN: We performed a quasi-experimental study in an intervention group of 191 patients with lung cancer attended through the RDTP circuit and a comparison group of 171 patients attended through the routine hospital circuit. Groups were matched for age and patterns of presentation. Multivariate analysis adjusting for different factors was performed. RESULTS: The median DTI was 36 days for the RDTP group and 45 days for the comparison group (P = 0.021). More patients in the RDTP group had advanced stage illness (III-IV) than in the comparison group (P = 0.032). In the multivariate analysis, none of these associations was statistically significant. Regardless of the type of circuit, a DTI <30 days was associated with disseminated disease (OR 3.28, P = 0.003). CONCLUSIONS: In this study, the RDTP circuit failed to reduce DTI and influence stage. Our results suggest tumor stage is the main determinant of both DTI and disease outcome.
Authors: Helen Hall; Adam Tocock; Sarah Burdett; David Fisher; William M Ricketts; John Robson; Thomas Round; Sarita Gorolay; Emma MacArthur; Donna Chung; Sam M Janes; Michael D Peake; Neal Navani Journal: Thorax Date: 2021-08-17 Impact factor: 9.102