title: [Fast diagnostic track for suspected lung cancer: A patient centered approach].
abstract: BACKGROUND
  The aim of this study is to describe the characteristics of patients who underwent a fast diagnostic track (FDT) due to suspected lung cancer at Landspitali University Hospital, Iceland.
  
  
  METHODS
  Hospital records were reviewed on background characteristics, diagnosis, staging, waiting times and survival of all 550 patients (mean age 68.1 years, 57% female) that participated in the FDT from February 1, 2008 to January 31, 2015. Adjusting for clinical characteristics in a multivariate analysis, overall survival was compared for patients diagnosed with lung cancer within or outside the FDT in Iceland in 2014 (n=167, mean age 69.3 years, 61.7% female).
  
  
  RESULTS
  Of the 550 FDT patients, 426 were diagnosed with lung cancer (77.5%); 346 of the non-small cell type (NSCLC) (81.2%). The proportion of patients receiving lung cancer diagnosis through the FDT increased from 23.3% in 2008 to 47.9% in 2014 (p<0.001). The waiting time from referral to diagnosis was 10 days median and 19 days from diagnosis to initiation of treatment. More patients with advanced disease were diagnosed outside the FDT (70.1% vs. 37.5%, p<0.05). When ad-- justed for age, sex, histology, stage at diagnosis and therapy, patients diagnosed with lung cancer outside the FDT had higher risk of all-cause mortality (HR 1.60; 95% CI: 0.95 - 2.71) although the difference was not statistically significant.
  
  
  CONCLUSIONS
  An increasing proportion of lung cancer diagnosis in Iceland is made through a fast diagnostic track with potential benefits for patients. The waiting time from referral to diagnosis and treatment is in line with international guidelines. Key words: lung cancer, non-small cell lung cancer, diagnostic track, waiting times, survival. Correspondence: Hronn Hardardottir, hronnh@landspitali.is.
authors.forename: Hronn
authors.initials: H
authors.lastname: Hardardottir
authors.forename: Unnur A
authors.initials: UA
authors.lastname: Valdimarsdottir
authors.forename: Tomas
authors.initials: T
authors.lastname: Gudbjartsson
authors.forename: Andres
authors.initials: A
authors.lastname: Sigvaldason
authors.forename: Sigrun Helga
authors.initials: SH
authors.lastname: Lund
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.forename: Sif
authors.initials: S
authors.lastname: Hansdottir
authors.forename: Steinn
authors.initials: S
authors.lastname: Jonsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019091:Critical Pathways; D019033:Delivery of Health Care, Integrated; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007055:Iceland; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010348:Patient Care Team; D018802:Patient-Centered Care; D011237:Predictive Value of Tests; D012017:Referral and Consultation; D013997:Time Factors; D061665:Time-to-Treatment