title: Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey.
abstract: OBJECTIVE
  The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays.
  
  
  METHODS
  A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.5±10.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces.
  
  
  RESULTS
  The patient delay was found to be 49.9±96.9 days, doctor delay was found to be 87.7±99.6 days, and total delay was found to be 131.3±135.2 days. The referral delay was found to be 61.6±127.2 days, diagnostic delay was found to be 20.4±44.5 days, and treatment delay was found to be 24.4±54.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (p<0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (p<0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (p<0.05).
  
  
  CONCLUSIONS
  The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly.
authors: Pulmonary Department, Gazi University School of Medicine, Ankara, Turkey. Electronic address: ayurdakul@gazi.edu.tr.
authors: Ahmet Selim
authors: AS
authors: Yurdakul
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Celalettin
authors: C
authors: Kocatürk
authors: Pulmonary Department, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
authors: Hülya
authors: H
authors: Bayiz
authors: Thoracic Surgery Department, İzmir Suat Seren Chest Diseases and Chest Surgery Education and Research Hospital, İzmir, Turkey.
authors: Soner
authors: S
authors: Gürsoy
authors: Pulmonary Department, Suleyman Demirel University School of Medicine, Isparta, Turkey.
authors: Ahmet
authors: A
authors: Bircan
authors: Pulmonary Department, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
authors: Aysenaz
authors: A
authors: Özcan
authors: Pulmonary Department, Dokuz Eylül University School of Medicine, Ankara, Turkey.
authors: Atilla
authors: A
authors: Akkoçlu
authors: Pulmonary Department, Dokuz Eylül University School of Medicine, Ankara, Turkey.
authors: Funda
authors: F
authors: Uluorman
authors: Pulmonary Department, Celal Bayar University School of Medicine, Manisa, Turkey.
authors: Pinar
authors: P
authors: Çelik
authors: Pulmonary Department, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
authors: Deniz
authors: D
authors: Köksal
authors: Pulmonary Department, Mersin University School of Medicine, Mersin, Turkey.
authors: Bahar
authors: B
authors: Ulubaş
authors: Pulmonary Department, Mersin University School of Medicine, Mersin, Turkey.
authors: Eylem
authors: E
authors: Sercan
authors: Pulmonary Department, Akdeniz University School of Medicine, Antalya, Turkey.
authors: Ömer
authors: Ö
authors: Özbudak
authors: Pulmonary Department, Ege University School of Medicine, İzmir, Turkey.
authors: Tuncay
authors: T
authors: Göksel
authors: Pulmonary Department, Ege University School of Medicine, İzmir, Turkey.
authors: Tuğba
authors: T
authors: Önalan
authors: Thoracic Surgery Department, İzmir Suat Seren Chest Diseases and Chest Surgery Education and Research Hospital, İzmir, Turkey.
authors: Esra
authors: E
authors: Yamansavci
authors: Pulmonary Department, Pamukkale University School of Medicine, Denizli, Turkey.
authors: Figen
authors: F
authors: Türk
authors: Pulmonary Department, Pamukkale University School of Medicine, Denizli, Turkey.
authors: Gökhan
authors: G
authors: Yuncu
authors: Pulmonary Department, Ankara Oncology Hospital, Ankara, Turkey.
authors: Çiğdem
authors: Ç
authors: Çopuraslan
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Tuğba
authors: T
authors: Mardal
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Esin
authors: E
authors: Tuncay
authors: Thoracic Surgery Department, Trakya University School of Medicine, Edirne, Turkey.
authors: Altemur
authors: A
authors: Karamustafaoğlu
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Pinar
authors: P
authors: Yildiz
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Funda
authors: F
authors: Seçik
authors: Medical Onology Department, Dicle University School of Medicine, Diyarbakir, Turkey.
authors: Muhammet
authors: M
authors: Kaplan
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Emel
authors: E
authors: Çağlar
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Mediha
authors: M
authors: Ortaköylü
authors: Pulmonary Department, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
authors: Mine
authors: M
authors: Önal
authors: Thoracic Surgery Department, Cerrahpasa University School of Medicine, Istanbul, Turkey.
authors: Akif
authors: A
authors: Turna
authors: Thoracic Surgery Department, Cerrahpasa University School of Medicine, Istanbul, Turkey.
authors: Evlin
authors: E
authors: Hekimoğlu
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Levent
authors: L
authors: Dalar
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Sedat
authors: S
authors: Altin
authors: Pulmonary Department, Ufuk University School of Medicine, Ankara, Turkey.
authors: Meral
authors: M
authors: Gülhan
authors: Pulmonary Department, Ufuk University School of Medicine, Ankara, Turkey.
authors: Eylem
authors: E
authors: Akpinar
authors: Pulmonary Department, Ankara University School of Medicine, Ankara, Turkey.
authors: İsmail
authors: İ
authors: Savas
authors: Pulmonary Department, Ankara University School of Medicine, Ankara, Turkey.
authors: Nalan
authors: N
authors: Firat
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Güngör
authors: G
authors: Çamsari
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Gülçihan
authors: G
authors: Özkan
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Erdoğan
authors: E
authors: Çetinkaya
authors: Pulmonary and Thoracic Surgery Department, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul, Turkey.
authors: Emine
authors: E
authors: Kamiloğlu
authors: Statistics Department, Gazi University School of Health Sciences, Ankara, Turkey.
authors: Bülent
authors: B
authors: Çelik
authors: Pulmonary Department, Celal Bayar University School of Medicine, Manisa, Turkey.
authors: Yavuz
authors: Y
authors: Havlucu
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000628:therapy; D057210:Delayed Diagnosis / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010820:Physicians; D013997:Time Factors; D014421:Turkey
keywords: Delay; Doctor; Lung cancer; Patient