title: Time to treat: a system redesign focusing on decreasing the time from suspicion of lung cancer to diagnosis.
abstract: BACKGROUND
  Multiple investigations often result in a lengthy process from the onset of lung cancer-related symptoms until diagnosis. An unpublished chart audit indicated suboptimal delays in patients' courses from onset of symptoms until diagnosis of cancer.
  
  
  METHODS
  The Time to Treat Program was designed for patients with clinical or radiographic suspicion of lung cancer. Pre- and postimplementation data on median wait times were compared.
  
  
  RESULTS
  From April 2005 to January 2007, 430 patients were referred. After Time to Treat Program implementation, the median time from suspicion of lung cancer to referral for specialist consultation decreased from 20 days to 6 days, and the median time from such referral to the actual consultation date decreased from 17 days to 4 days. The median time from specialist consultation to computed tomography scan decreased from 52 days to 3 days, and the median time from computed tomography scan to diagnosis decreased from 39 days to 6 days. Overall, the median time from suspicion of lung cancer to diagnosis decreased from 128 days to 20 days. Of all patients in the Time to Treat Program, 33% were eventually diagnosed with lung cancer.
  
  
  CONCLUSIONS
  Time to Treat Program was effective in shortening the time from suspicion of lung cancer to diagnosis and reduced time intervals at each step in the process. Earlier diagnosis of lung cancer may allow increased treatment options for patients and may improve outcomes.
authors.affiliation: Medical Oncology, University of Toronto, Toronto, Ontario, Canada. drdorothylo@gmail.com
authors.forename: Dorothy S
authors.initials: DS
authors.lastname: Lo
authors.forename: Robert A
authors.initials: RA
authors.lastname: Zeldin
authors.forename: Roland
authors.initials: R
authors.lastname: Skrastins
authors.forename: Ian M
authors.initials: IM
authors.lastname: Fraser
authors.forename: Harold
authors.initials: H
authors.lastname: Newman
authors.forename: Alan
authors.initials: A
authors.lastname: Monavvari
authors.forename: Yee C
authors.initials: YC
authors.lastname: Ung
authors.forename: Harry
authors.initials: H
authors.lastname: Joseph
authors.forename: Teresa
authors.initials: T
authors.lastname: Downton
authors.forename: Larissa
authors.initials: L
authors.lastname: Maxwell
authors.forename: Jacinta
authors.initials: J
authors.lastname: Meharchand
mesh_terms: D000368:Aged; D000465:Algorithms; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000628:therapy; D003657:Decision Making; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D009367:Neoplasm Staging; D010347:Patient Care Planning / Q000458:organization & administration*; D011379:Prognosis; D012017:Referral and Consultation; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed