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Timeliness of lung cancer care in Victoria: a retrospective cohort study

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More Australian men and women die from lung cancer than from any other cancer.1 It is the fourth most common neoplasm in both men and women, and in 2014 more than 11 000 people were diagnosed with lung cancer in Australia.1 The 5-year survival rate is 14%;1 the median survival time for patients with non-small cell lung cancer (NSCLC) is 6.9 months, and for small cell lung cancer (SCLC) it is 7.2 months.2

A recent Victorian study found that only 30% of patients with NSCLC received treatment with curative intent, and only 33% were discussed in a multidisciplinary team meeting.2 While 26% of patients presented with stage III disease, only 8% had invasive staging of the mediastinum, highlighting a potential discordance in staging of the cancer. The study did not assess delays in the care pathway.

In addition to obvious psychological distress, delay in managing lung cancer increases the potential for disease progression before treatment and may reduce the capacity for treatment with curative intent.3 Brocken and colleagues categorised delay as either “first-line”, caused by delays in the patient seeking medical advice or a delay in management by the general practitioner, or “second-line”, caused by delays in referral…

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