BACKGROUND: National guidelines in England recommend prompt chest X-ray (within 14 days) in patients presenting in general practice with unexplained symptoms of possible lung cancer, including persistent cough, shortness of breath, or weight loss. AIM: To examine time to chest X-ray in symptomatic patients in English general practice before lung cancer diagnosis, and explore demographical variation. DESIGN AND SETTING: Retrospective cohort study using routinely collected general practice, cancer registry, and imaging data from England. METHOD: Patients with lung cancer who presented symptomatically in general practice in the year pre-diagnosis and who had a pre-diagnostic chest X-ray were included. Time from presentation to chest X-ray (presentation-test interval) was determined and intervals classified based on national guideline recommendations as concordant (≤14 days) or non-concordant (>14 days). Variation in intervals was examined by age, sex, smoking status, and deprivation. RESULTS: In a cohort of 2102 patients with lung cancer, the median presentation-test interval was 49 (interquartile range [IQR] 5-172) days. Of these, 727 (35%) patients had presentation-test intervals of ≤14 days (median 1 [IQR 0-6] day) and 1375 (65%) had presentation-test intervals of >14 days (median 128 [IQR 52-231] days). Intervals were longer among patients who smoke (equivalent to 63% longer than non-smokers; P<0.001), older patients (equivalent to 7% longer for every 10 years from age 27; P = 0.013), and females (equivalent to 12% longer than males; P = 0.016). CONCLUSION: In symptomatic primary care patients who underwent chest X-ray before lung cancer diagnosis, only 35% were tested within the timeframe recommended by national guidelines. Patients who smoke, older patients, and females experienced longer intervals. These findings could help guide initiatives aimed at improving timely lung cancer diagnosis.
BACKGROUND: National guidelines in England recommend prompt chest X-ray (within 14 days) in patients presenting in general practice with unexplained symptoms of possible lung cancer, including persistent cough, shortness of breath, or weight loss. AIM: To examine time to chest X-ray in symptomatic patients in English general practice before lung cancer diagnosis, and explore demographical variation. DESIGN AND SETTING: Retrospective cohort study using routinely collected general practice, cancer registry, and imaging data from England. METHOD:Patients with lung cancer who presented symptomatically in general practice in the year pre-diagnosis and who had a pre-diagnostic chest X-ray were included. Time from presentation to chest X-ray (presentation-test interval) was determined and intervals classified based on national guideline recommendations as concordant (≤14 days) or non-concordant (>14 days). Variation in intervals was examined by age, sex, smoking status, and deprivation. RESULTS: In a cohort of 2102 patients with lung cancer, the median presentation-test interval was 49 (interquartile range [IQR] 5-172) days. Of these, 727 (35%) patients had presentation-test intervals of ≤14 days (median 1 [IQR 0-6] day) and 1375 (65%) had presentation-test intervals of >14 days (median 128 [IQR 52-231] days). Intervals were longer among patients who smoke (equivalent to 63% longer than non-smokers; P<0.001), older patients (equivalent to 7% longer for every 10 years from age 27; P = 0.013), and females (equivalent to 12% longer than males; P = 0.016). CONCLUSION: In symptomatic primary care patients who underwent chest X-ray before lung cancer diagnosis, only 35% were tested within the timeframe recommended by national guidelines. Patients who smoke, older patients, and females experienced longer intervals. These findings could help guide initiatives aimed at improving timely lung cancer diagnosis.
Authors: Brian D Nicholson; David Mant; Richard D Neal; Nigel Hart; Willie Hamilton; Bethany Shinkins; Greg Rubin; Peter W Rose Journal: Br J Gen Pract Date: 2016-01-06 Impact factor: 5.386
Authors: Clare Pearson; Jess Fraser; Michael Peake; Roland Valori; Veronique Poirier; Victoria H Coupland; Sara Hiom; Sean McPhail; Jodie Moffat; Georgios Lyratzopoulos; Jon Shelton Journal: Cancer Epidemiol Date: 2019-06-15 Impact factor: 2.984
Authors: Margo M Jacobsen; Sophie C Silverstein; Michael Quinn; Leo B Waterston; Christian A Thomas; James C Benneyan; Paul K J Han Journal: Lung Cancer Date: 2017-08-15 Impact factor: 5.705
Authors: R D Neal; P Tharmanathan; B France; N U Din; S Cotton; J Fallon-Ferguson; W Hamilton; A Hendry; M Hendry; R Lewis; U Macleod; E D Mitchell; M Pickett; T Rai; K Shaw; N Stuart; M L Tørring; C Wilkinson; B Williams; N Williams; J Emery Journal: Br J Cancer Date: 2015-03-31 Impact factor: 7.640
Authors: Yin Zhou; Fiona M Walter; Luke Mounce; Gary A Abel; Hardeep Singh; Willie Hamilton; Grant D Stewart; Georgios Lyratzopoulos Journal: Br J Gen Pract Date: 2021-12-31 Impact factor: 5.386