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Carole Saint-Pierre
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P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.15-13 - Wait Times for Diagnosis and Treatment of Lung Cancer Across the Province of Quebec, Canada (ID 13472)
16:45 - 18:00 | Author(s): Carole Saint-Pierre
- Abstract
Background
Multiple clinical practice guidelines recommend rapid evaluation of patients with suspected lung cancer. Diagnostic pathways and wait times vary considerably from one centre to another.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively reviewed medical records of all patients (n=1217) across the province of Quebec who had a biopsy-proven diagnosis of lung cancer between February 1st and April 30th, 2017. Median wait times for diagnosis and treatment were calculated.
4c3880bb027f159e801041b1021e88e8 Result
Patient characteristics are shown in Table 1. Median wait times for investigation and treatment are shown in Table 2. There were variations between centres and regions.
Characteristic
No (%)
Age, years, mean (range)
68.5 (20-94)
Male sex
585 (48)
Smoking status
Former or current smoker
Never smoker
Unknown
1120 (92)
60 (5)
37 (3)
ECOG performance status
0
1
≥2
Missing
416 (34)
358 (30)
393 (32)
50 (4)
Histology
Adenocarcinoma
631 (52)
Squamous cell carcinoma
284 (23)
NSCLC NOS
70 (6)
SCLC
178 (15)
Other
54 (4)
TNM stage
I
213 (18)
II
114 (9)
III
227 (19)
IV
475 (39)
Limited SCLC
40 (3)
Extensive SCLC
138 (11)
Missing
10 (1)
Known positive EGFR mutation status (n=395 tested)
Known positive ALK translocation status (n=387 tested)
PD-L1 TPS (n=386 tested)
<1%
1-49%
≥50%
Number of investigations per patient, median (IQR)
28 (7)
6 (2)
85 (22)
151 (39)
150 (39)
7 (6, 8)
Tumor board review
194 (16)
Final diagnostic procedure
Flexible bronchoscopy
338 (28)
EBUS/EUS
223 (18)
Transthoracic needle biopsy
301 (25)
Thoracoscopy
139 (11)
Biopsy of metastatic site
145 (12)
Sputum cytology
1 (0)
Thoracentesis
61 (5)
Mediastinoscopy
Missing
2 (0)
7 (1)
ECOG = Eastern Cooperative Oncology Group; NSCLC = non-small cell lung cancer; NOS = not otherwise specified; SCLC = small cell lung cancer; EGFR = epidermal growth factor receptor; ALK = anaplastic lymphoma kinase; TPS = tumor proportion score; IQR = interquartile range; EBUS = endobronchial ultrasonography; EUS = endoscopic ultrasonography.
Table 2 – Median wait times for investigation and treatment
8eea62084ca7e541d918e823422bd82e ConclusionInvestigation or treatment interval
Pts (n)
Median wait, days (IQR)
Referral to first appointment with specialist
972
2 (0, 7)
First appointment to diagnosis
1152
18 (8, 43)
Diagnosis to first treatment
930
22 (5, 42)
Referral to first treatment
737
58 (28, 89)
Abnormal imaging to first treatment
902
72 (39, 111)
Surgery
268
109 (80, 142)
Radiation
362
59 (28, 98)
Systemic therapy
330
62 (35, 92)
To our knowledge, this is the largest multicentre review of wait times for diagnosis and treatment of lung cancer with detailed characteristics of patients. Data will be completed and updated prior to the meeting, to try to identify specific factors associated with longer wait times.
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