The time required to diagnose and treat lung cancer in Delhi, India: an updated experience of a public referral center
Appl. cancer res
;
39: 1-9, 2019. ilus, tab
Article
in English
| LILACS, Inca
| ID: biblio-1254267
ABSTRACT
Background:
Delays that postpone the evaluation and management of malignancy may lead to considerable morbidity. The primary objective of this study was to assess the time required to diagnose and treat lung cancer at an Indian public referral center that predominantly serves lower-income patients.Methods:
A review of patients diagnosed with lung cancer between January 2008 and December 2016 was completed. We computed the median time intervals and inter-quartile ranges between symptom onset, definitive diagnostic investigation, confirmed histologic diagnosis, and chemotherapy initiation. Median intervals were correlated with baseline demographics and disease characteristics using Kruskal-Wallis test.Results:
One thousand, three hundred and-seventy patients were selected. A majority (94.5%) with non-small cell lung cancer were diagnosed with advanced disease. After developing symptoms, patients required 101 [56168] days to undergo a definitive diagnostic study, 107 [60173] days to confirm a diagnosis, and 126 [85196.8] days to initiate treatment. Patients who were previously treated for tuberculosis required more time to receive chemotherapy compared to those who were not (187 [134261.5] days vs. 113 [75180] days, p < 0.0001). A specialty Lung Cancer Clinic was implemented in 2012, and the mean referrals per month increased nearly four-fold (p < 0.0001), but the time required to administer treatment was not shortened.Conclusion:
Among lower-income Indian patients, the most prominent delays occur prior to diagnosis. Efforts should be directed toward encouraging physicians to maintain a high index of clinical suspicion and educating patients to report concerning symptoms as early as possible.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Lung Neoplasms
Type of study:
Diagnostic study
Limits:
Adult
/
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
Appl. cancer res
Journal subject:
Neoplasms
Year:
2019
Type:
Article
Affiliation country:
India
/
United States
Institution/Affiliation country:
All India Institute of Medical Sciences/CD
/
All India Institute of Medical Sciences/IN
/
Duke University Health System/US
/
Mayo Clinic/US
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