title: Lung cancer interval times from point of referral to the acute health sector to the start of first treatment.
abstract: Objective The aim of the present study was to compare lung cancer diagnostic and treatment intervals with agreed target measures across three large public health services in Victoria and assess any differences in interval times by treatment type and health service. Methods A retrospective medical record audit of 78 patients admitted with a new diagnosis of lung cancer was conducted. Interval times from referral to diagnosis, diagnosis to first treatment and referral to first treatment were recorded in three treatment types: surgery, chemotherapy and radiotherapy. Results There was a significant difference in the mean number of days from referral to diagnosis by treatment type. Patients who underwent surgery waited significantly longer (mean (± s.d.) 41.6±38.4 days) to obtain a diagnosis than those who received radiotherapy (15.1±18.6 days). Only 47% of surgical patients obtained a diagnosis within the recommended 28 days. Moreover, only 45% and 44% of patients, respectively, met the diagnosis-to-treatment target of 14 days and referral-to-treatment target of 42 days. Conclusion The present study highlights the effect of treatment type on lung cancer referral interval times. It demonstrates the benefits of using evidenced-based interval target times to benchmark and compare performance outcomes in lung cancer. What is known about the topic? Lung cancer is the leading cause of cancer mortality in Australia and has the lowest 5-year survival rate of all cancer types. Delays in the diagnosis of lung cancer can change the prognosis from potentially curable to incurable, particularly in faster-growing tumours. What does this paper add? This study reveals treatment type was a greater factor in explaining variations in diagnosis and treatment than health service. Surgical patients were consistently lower in meeting the recommended interval targets across referral to diagnosis, diagnosis to treatment and referral to treatment. What are the implications for practitioners? This study demonstrates the value of using evidenced-based interval target times to benchmark and compare performance outcomes in lung cancer. Such measures may further improve prognostic outcomes in lung cancer by reducing unwanted delays.
authors.affiliation: Southern Melbourne Integrated Cancer Service (SMICS), PO Box 72, 823-865 Centre Road, East Bentleigh, Vic. 3165, Australia.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Largey
authors.affiliation: Monash University Department of Rural & Indigenous Health (MUDRIH), 3 Ollerton Avenue, Moe, Vic. 3825, Australia. Email: ; ;
authors.forename: Eli
authors.initials: E
authors.lastname: Ristevski
authors.affiliation: Monash University Department of Rural & Indigenous Health (MUDRIH), 3 Ollerton Avenue, Moe, Vic. 3825, Australia. Email: ; ;
authors.forename: Helen
authors.initials: H
authors.lastname: Chambers
authors.affiliation: Southern Melbourne Integrated Cancer Service (SMICS), PO Box 72, 823-865 Centre Road, East Bentleigh, Vic. 3165, Australia.
authors.forename: Heather
authors.initials: H
authors.lastname: Davis
authors.affiliation: Southern Melbourne Integrated Cancer Service (SMICS), PO Box 72, 823-865 Centre Road, East Bentleigh, Vic. 3165, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Briggs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment; D014739:Victoria