27P - Factors causing treatment delays and its impact on treatment outcome in patients of lung cancer: An analysis

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Cancer Aetiology, Epidemiology, Prevention
Lung and other Thoracic Tumours
Presenter Divyesh Kumar
Citation Annals of Oncology (2017) 28 (suppl_2): ii6-ii8. 10.1093/annonc/mdx087
Authors D. Kumar1, S. Singh2
  • 1Radiotherapy, Post Graduate Institute of Medical Education and Research (PGIMER), 160012 - Chandigarh/IN
  • 2CSM Medical University (KG's Medical University) Gandhi Memorial & Associated Hospital, Lucknow/IN

Abstract

Background

Delays in diagnosis and treatment are undesirable in cancer management. In this analysis, we tried to identify factors causing delay in diagnosis and subsequently its effect on outcome in patients of lung cancer presenting to the oncology department.

Methods

55 patients with proven histopathological diagnosis of lung cancer were interviewed. Results were analysed statistically.

Results

M:F=3:1.Mean age 49 years (32-65 years).NSCLC:SCLC=4:1, majorly adenocarcinoma. The duration of symptoms ranged from 1 month to 2 years. The number of illiterate patients presented mainly in advanced stages as compared to their educated counterparts and the difference was statistically significant (P<0.001). The number of patients presenting directly to the department was 8, those diagnosed outside and referred to us was 29 while those diagnosed and received some form of oncologic treatment outside and referred thereafter was 18. The difference in the primary delay between patients presenting directly to the institute versus those diagnosed outside was significant (P=0.01). The mean time to starting definitive treatment after presentation to the outpatient was 3 days (range 0-15 days) and was very significantly (P< 0.001) less than the secondary delays caused to the other two subsets of patients. The most important patient reasons for the delay in diagnosis were - financial constraints (20/55, 28.3%), ignorance about disease (9/55, 16.36%); dependency to escort (5/55, 9.0%), far off native place (7/55,12.7%), faith in local practitioner (3/55, 5.4%), family occasions (2/55, 3.6%), fear of death (2/55, 3.6%). 4/55 (7.2%) were initially diagnosed as tuberculosis and hence the delay, and 3/55 (5.4%) had no reason cited. Stages at diagnosis were stage II (4/55, 7.2%), stage III (41/55, 74.5%), stage IV (10/55,18.1%). Advanced stage disease patients had statistically significant poorer outcomes compared with those with earlier stage disease.

Conclusions

Factors causing delayed presentation are both patient and system related. Awareness regarding the early signs and symptoms of lung cancer should be encouraged through various media channels. At the same time, the system needs to intensify its efficiency to avoid secondary delays that adversely affect the treatment outcome.

Clinical trial identification

not applicable

Legal entity responsible for the study

N/A

Funding

None

Disclosure

All authors have declared no conflicts of interest.