title: Impact of a program for rapid diagnosis and treatment of lung cancer on hospital care delay and tumor stage.
abstract: OBJECTIVE
  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
  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: Anna
authors: A
authors: Selva
authors: Ignasi
authors: I
authors: Bolíbar
authors: Alfons
authors: A
authors: Torrego
authors: Maria Cinta
authors: MC
authors: Pallarès
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003695:Delivery of Health Care / Q000379:methods* / Q000639:trends; D005260:Female; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015397:Program Evaluation; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D061665:Time-to-Treatment