title: Outcome in patients with lung cancer found on lung cancer mass screening roentgenograms, but who did not subsequently consult a doctor.
abstract: OBJECTIVE
  To evaluate the outcome in patients with lung cancer found on lung cancer mass screening roentgenograms, but who did not subsequently consult a doctor.
  
  
  METHODS
  This study enrolled 198 asymptomatic patients with lung cancer found by lung cancer mass screening during the 9-year period. Five-year survival rates in patients who did not consult a doctor or who stopped consulting a doctor in spite of abnormal shadows detected on last mass screening chest roentgenograms (n=45, delayed consultation group) and in patients who subsequently consulted a doctor when abnormal shadows were detected (n=153, control group) were evaluated by the method of Kaplan and Meier and clinical variables were examined as possible predictors of survival time by the Cox proportional-hazards model.
  
  
  RESULTS
  There was a significant difference between the 5-year survival rates in the delayed consultation group and in the control group (21 vs. 51%, log rank: P=0.0003, Wilcoxon: P=0.0009). The risk of death increased 115.0% for the 1-year delay in consultation (hazard ratio: 2.150, 95% CI: 1.203-3.842, P=0.0097). With regard to the reason why they did not consult a doctor, many of them answered that they did not have any respiratory symptoms.
  
  
  CONCLUSIONS
  The 1-year delay in consultation had a great significance in that these patients did not receive any treatment for lung cancer for 1 year, and the 1-year delay in treatment itself affected the outcome.
authors.affiliation: Respiratory Department, Taragi Municipal Hospital, 4210 Taragi-machi, Kuma-gun, Kumamoto 868-0501, Japan. cbi54000@pop02.odn.ne.jp
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kashiwabara
authors.forename: Syu-ichi
authors.initials: S
authors.lastname: Koshi
authors.forename: Kotaro
authors.initials: K
authors.lastname: Itonaga
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakahara
authors.forename: Makoto
authors.initials: M
authors.lastname: Tanaka
authors.forename: Masakazu
authors.initials: M
authors.lastname: Toyonaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008400:Mass Chest X-Ray / Q000706:statistics & numerical data*; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012017:Referral and Consultation; D012308:Risk Management; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome