Locally advanced and metastatic lung cancer management delay: Tunisian department experience

Introduction: Lung cancer is the leading cause of cancer-related mortalityworldwide , 5-years survival is just 15%; despite medical progress, mortality rate decreases very slowly.This poor prognosis is due to diagnosis delay. Aims: To evaluate the delay between onset of symptoms, consultation delay and the lung cancer diagnosis. Methods: Retrospective study assessing 180 clinical diagnosis of non-small lung cancer in our Charles Nicolle pneumology department between January 2007 and December 2014. Results: The average age of our patients (pts) was 61.5 year old with a male predominance (93.3%)Consultation delay was 93.6 days (0 to 720 days).Over than 65 years-old pts consult before the youngest (p= 0.011).Pts with poor general condition consult later (0.041).For the other studied factors, it was not found a statistically significant difference.Diagnosis delay was 39.8 days(3 to 240 days)Analyzed factors for this delay were: tumor site and histopathologicalconfirmation way.Pulmonary transparietal biopsy lengthen diagnosis delays (p= 0.04).There was also a relation between tumor site and diagnosis delay (p= 0.000).Treatment delay was 48 days (7 to 270 days).Chemotherapy increase this delay(p =0.001).Global median survival was 6months.1-year and 2-years survival were 30% and 18% respectively.Poor prognosis factors were: PS, early management delay ( 45 days. Conclusion: Prompt management is an important dimension for pts suffering from lung cancer.Our study has found very long prehospital and hospital delays.More efforts are needed to improve lung cancer management and prognosis.