Pathways to diagnosis of non-small cell lung cancer : a descriptive cohort study

Stuart Purdie; Nicola Creighton; Kahren Maree White; Deborah Baker; Dan Ewald; Chee Khoon Lee; Alison Lyon; Johnathan Man; David Michail; Alexis Andrew Miller; Lawrence Tan; David Currow; Jane M. Young

doi:10.1038/s41533-018-0113-7

Pathways to diagnosis of non-small cell lung cancer : a descriptive cohort study

Stuart Purdie, Nicola Creighton, Kahren Maree White, Deborah Baker, Dan Ewald, Chee Khoon Lee, Alison Lyon, Johnathan Man, David Michail, Alexis Andrew Miller, Lawrence Tan, David Currow, Jane M. Young

Western Sydney University

Research output: Contribution to journal › Article › peer-review

Abstract

Little has been published on the diagnostic and referral pathway for lung cancer in Australia. This study set out to quantify general practitioner (GP) and lung specialist attendance and diagnostic imaging in the lead-up to a diagnosis of non-small cell lung cancer (NSCLC) and identify common pathways to diagnosis in New South Wales (NSW), Australia. We used linked health data for participants of the 45 and Up Study (a NSW population-based cohort study) diagnosed with NSCLC between 2006 and 2012. Our main outcome measures were GP and specialist attendances, X-rays and computed tomography (CT) scans of the chest and lung cancer-related hospital admissions. Among our study cohort (N = 894), 60% (n = 536) had ≥4 GP attendances in the 3 months prior to diagnosis of NSCLC, 56% (n = 505) had GP-ordered imaging (chest X-ray or CT scan), 39% (N = 349) attended a respiratory physician and 11% (N = 102) attended a cardiothoracic surgeon. The two most common pathways to diagnosis, accounting for one in three people, included GP and lung specialist (respiratory physician or cardiothoracic surgeon) involvement. Overall, 25% of people (n = 223) had an emergency hospital admission. For 14% of people (N = 129), an emergency hospital admission was the only event identified on the pathway to diagnosis. We found little effect of remoteness of residence on access to services. This study identified a substantial proportion of people with NSCLC being diagnosed in an emergency setting. Further research is needed to establish whether there were barriers to the timely diagnosis of these cases.

Original language	English
Article number	2
Number of pages	6
Journal	npj Primary Care Respiratory Medicine
Volume	29
DOIs	https://doi.org/10.1038/s41533-018-0113-7
Publication status	Published - 2019

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Keywords

cancer
diagnosis
lungs

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/s41533-018-0113-7

Cite this

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title = "Pathways to diagnosis of non-small cell lung cancer : a descriptive cohort study",

abstract = "Little has been published on the diagnostic and referral pathway for lung cancer in Australia. This study set out to quantify general practitioner (GP) and lung specialist attendance and diagnostic imaging in the lead-up to a diagnosis of non-small cell lung cancer (NSCLC) and identify common pathways to diagnosis in New South Wales (NSW), Australia. We used linked health data for participants of the 45 and Up Study (a NSW population-based cohort study) diagnosed with NSCLC between 2006 and 2012. Our main outcome measures were GP and specialist attendances, X-rays and computed tomography (CT) scans of the chest and lung cancer-related hospital admissions. Among our study cohort (N = 894), 60% (n = 536) had ≥4 GP attendances in the 3 months prior to diagnosis of NSCLC, 56% (n = 505) had GP-ordered imaging (chest X-ray or CT scan), 39% (N = 349) attended a respiratory physician and 11% (N = 102) attended a cardiothoracic surgeon. The two most common pathways to diagnosis, accounting for one in three people, included GP and lung specialist (respiratory physician or cardiothoracic surgeon) involvement. Overall, 25% of people (n = 223) had an emergency hospital admission. For 14% of people (N = 129), an emergency hospital admission was the only event identified on the pathway to diagnosis. We found little effect of remoteness of residence on access to services. This study identified a substantial proportion of people with NSCLC being diagnosed in an emergency setting. Further research is needed to establish whether there were barriers to the timely diagnosis of these cases.",

keywords = "cancer, diagnosis, lungs",

author = "Stuart Purdie and Nicola Creighton and White, {Kahren Maree} and Deborah Baker and Dan Ewald and Lee, {Chee Khoon} and Alison Lyon and Johnathan Man and David Michail and Miller, {Alexis Andrew} and Lawrence Tan and David Currow and Young, {Jane M.}",

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AU - Creighton, Nicola

AU - White, Kahren Maree

AU - Baker, Deborah

AU - Ewald, Dan

AU - Lee, Chee Khoon

AU - Lyon, Alison

AU - Man, Johnathan

AU - Michail, David

AU - Miller, Alexis Andrew

AU - Tan, Lawrence

AU - Currow, David

AU - Young, Jane M.

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AB - Little has been published on the diagnostic and referral pathway for lung cancer in Australia. This study set out to quantify general practitioner (GP) and lung specialist attendance and diagnostic imaging in the lead-up to a diagnosis of non-small cell lung cancer (NSCLC) and identify common pathways to diagnosis in New South Wales (NSW), Australia. We used linked health data for participants of the 45 and Up Study (a NSW population-based cohort study) diagnosed with NSCLC between 2006 and 2012. Our main outcome measures were GP and specialist attendances, X-rays and computed tomography (CT) scans of the chest and lung cancer-related hospital admissions. Among our study cohort (N = 894), 60% (n = 536) had ≥4 GP attendances in the 3 months prior to diagnosis of NSCLC, 56% (n = 505) had GP-ordered imaging (chest X-ray or CT scan), 39% (N = 349) attended a respiratory physician and 11% (N = 102) attended a cardiothoracic surgeon. The two most common pathways to diagnosis, accounting for one in three people, included GP and lung specialist (respiratory physician or cardiothoracic surgeon) involvement. Overall, 25% of people (n = 223) had an emergency hospital admission. For 14% of people (N = 129), an emergency hospital admission was the only event identified on the pathway to diagnosis. We found little effect of remoteness of residence on access to services. This study identified a substantial proportion of people with NSCLC being diagnosed in an emergency setting. Further research is needed to establish whether there were barriers to the timely diagnosis of these cases.

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KW - diagnosis

KW - lungs

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Pathways to diagnosis of non-small cell lung cancer : a descriptive cohort study

Abstract

Open Access - Access Right Statement

Keywords

UN SDGs

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