The lung cancer journey - a review from the prince charles hospital pulmonary malignancy unit

Introduction: The aim of this study is to identify factors affecting intervals between critical nodes in the referral and medical assessment pathways up to the point of initial treatment for patients with suspected lung cancer. Method: A review of the Pulmonary Malignancy Unit database and medical records for patients referred between January2010 and June 2010 with suspicion of lung cancer was conducted. Results: A total of 138 patients were referred during this interval. Journey intervals were ascertained for 30 of these patients referred in January/February and whose records were readily retrieved. The average time from referral to diagnosis was 30 23.45 days (range 3-64 days). The time between first medical assessment at the hospital to clinicopathologic diagnosis was 16.5 17.3 days. Patients whose diagnostic interval exceeded one SD above the mean had explanatory factors including need for invasive diagnostic procedures other than bronchoscopy or fine needle aspiration, and significant co-morbidities or recent acute illness where an opinion from other specialists was required. The average time from diagnosis to the commencement of treatment was 36 33 days. Factors shown to influence the treatment interval were mainly the need for radiotherapy and further staging imaging e.g. PET scans, both of which are conducted at another health facility.Conclusion: On a limited sample from a pulmonary malignancy referral unit at a major public hospital to date, reasons for longer intervals between referral and first treatment, were readily identifiable.