Objectives
This study aims to investigate the diagnosis and medical delay among lung cancer patients, furthermore, the involvement of the SARS-CoV-2 pandemic in diagnostic delay.
Methods
The retrospective study was performed in Pulmonology Department at Fejer County University Teaching Hospital in Hungary, between January 1, 2019 and December 31, 2020. We analysed the data of patients with primary lung cancer and changes in the diagnostic and medical delay time (n=102). Descriptive statistical analyses were applied (mean, standard deviation, absolute and relative frequency).
Results
The average age is 68 years. 44.1% of patients were admitted to the institution from lung care, 12.7% from the emergency department and 43.1% from other providers. The mean diagnostic delay was 89.8±47.9 days in the two years. The time from first appointment to the chest CT was 21.42±28.08 days. On average, 21.93±25.1 days elapsed from CT to bronchoscopy. On average 35.79±29.2 days elapsed between oncoteam consultation and initiation of treatment. For those requiring PET/CT, the total diagnostic time increased from 69.7 days to 119.6 days (p<0.001). The total diagnostic time of patients receiving chemotherapy (22.9 days) was significantly lower compared to both patients receiving surgery (50.9 days) and those receiving radiotherapy (101.3 days) (p<0.001). In 2020, the number of primary lung care appointments decreased significantly, from 58% to 31% of all primary care visits, while the proportion of primary appointments in other care settings increased significantly from 2019 to 2020, from 28% to 58% (p=0.008). No significant difference was observed in the mean of the total diagnostic delay times (p=0.273), it was 83.8±47.9 days in 2019 and then 94.7± 47.8 days.
Conclusions
Reducing the therapeutic delay – which constitutes a substantial part of the total diagnostic period, is a realistic goal and should be targeted.