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A. Hanks



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    P1.24 - Poster Session 1 - Clinical Care (ID 146)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P1.24-003 - A comparison of the Lung Cancer journey - Metropolitan and Non-Metropolitan (ID 674)

      09:30 - 16:30  |  Author(s): A. Hanks

      • Abstract

      Background
      Referrals and diagnostic pathways for people with symptoms of suspected lung cancer vary by where a person lives and ease of accessing services. Lung cancer diagnostic specialist and treatment services are mostly located in major cities, which can make access for people living in regional/rural and remote areas more difficult compared to major cities. Studies have shown that remoteness of residence is associated with an increase of lung cancer incidence and mortality. Hypothesis: The time required for the evaluation of suspected lung cancer is longer for people from regional/rural and remote areas compared to people living in metropolitan Queensland. The aim of the research study is to describe and compare the journey from referral to diagnosis for people with suspected lung cancer from regional/rural and remote areas referred to The Prince Charles Hospital , a tertiary referral center, compared to metropolitan residents.

      Methods
      A retrospective study of consecutive people with suspected lung cancer referred to The Prince Charles Hospital from December 2010 onwards will be reviewed. Data on patient demographics and referral patterns will be collected from medical records and relevant Queensland Health patient information systems. Information systems include Queensland Oncology Online, Queensland Oncology Analysis System (OASys), The Viewer, Hospital Based Corporate Information System (HBCIS), Practix, Outpatient Services Information Management (OSIM), Picture Archive and Communication System (PACS) and Auscare. The following times will be compared between regional/rural/remote (defined as >50km from TPCH) and metropolitan (<50km from TPCH) patients: (A) from receipt of referral to first specialist appointment (FSA), (B) FSA to first pathological (cytology or histology) diagnosis (FPD), (C) FPD to first multidisiciplinary team discussion (MDT) and (D) MDT to first definitive treatment (FDT). .

      Results
      Preliminary results show that there are clear differences in times to first specialist appointments, diagnosis and definitive treatment experienced by patients living in more regional and remote areas compared to patients from the metropolitan area. Patients from more regional and remote areas on average waited longer for their first specialist appointments e.g. Non Metro: N= 103 60% of patients seen within 30 days of a written referral and 28% were seen within 7 days. Metro: N= 60 78% patients seen within 30 days of a written referral and 50% were seen within 7 days There was also a pattern of admitting patients from remote areas to have all diagnostic workup and commence treatment as an inpatient. Admitting patients from remote areas for diagnostic workup appears to have decreased time to treatment for this cohort of patients although the cost effectivenss to the health service is unknown.

      Conclusion
      Lung cancer is a devastating disease and has a poor prognosis. Lung cancer diagnostic and treatment pathways should be developed for patients living in more regional and remote areas of Queensland to ensure times to diagnosis and treatment are optimised. Potentially this will decrease emotional and financial strain suffered by patients and their families as well as being cost effective to health services.