Delays in the diagnosis and treatment  of non-small-cell lung cancer.
OBJECTIVE
To investigate patterns of delays among patients with non-small-cell lung cancer and to identify reasons for the delays.


METHODS
This prospective study included 101 patients with non-small-cell lung carcinoma. Clinical files of the patients were analyzed and a questionnaire was created to obtain data. Several time intervals and delays were determined for each patient. The reasons for the delays were also evaluated.


RESULTS
The mean time was 59.9 days for the application interval, 40.3 days for the referral interval, 16.4 days for the diagnostic interval, and 24.7 days for the treatment interval. The application interval was longer than 30 days (patient's delay) in 48 patients (48.5%). There was a doctor delay in 54 (53.5%) patients, a referral delay in 47 (46.5%) patients, a diagnostic delay in 37 (36.6%) patients, and a treatment delay in 57 (56.4%) patients. The mean total time was 119.6 days. Sixty-two patients (62.6%) had a total delay. The most common reason for patient's delay was neglect of symptoms by patients. A low index of suspicion for lung cancer was the most common cause for referral delay. The low performance of diagnostic tests was the frequent reason for diagnostic delay.


CONCLUSIONS
Patient's and doctor's delays were a common problem among patients with non-small-cell lung cancer. The rate of doctor's delay was higher than that of patient's delay. Several efforts such as education of the physicians and people about lung cancer should be made to reduce these delays.
Department of Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Investigation Hospital, Istanbul, Turkey.
Ebru
E
Sulu
Oktay
O
Tasolar
Huriye
H
Berk Takir
Leyla
L
Yagci Tuncer
Zuhal
Z
Karakurt
Adnan
A
Yilmaz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D057210:Delayed Diagnosis; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012017:Referral and Consultation; D012307:Risk Factors; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology