RESEARCH PAPER
Reasons for delay in diagnosis and treatment of lung cancer among patients in Lublin Voivodeship who were consulted in Thoracic Surgery Department
 
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1
Department of Thoracic Surgery, Medical University, Lublin, Poland
 
2
Chair of Internal Medicine and Department of Internal Medicine in Nursing, Medical University, Lublin, Poland; Department of Pneumonology, Oncology and Allergology, Medical University, Lublin, Poland
 
3
Department of Pneumonology, Oncology and Allergology, Medical University, Lublin, Poland
 
4
Department of Pneumonology, Oncology and Allergology, Medical University, Lublin, Poland; Institute of Rural Health, Lublin, Poland
 
 
Ann Agric Environ Med. 2013;20(1):72-76
 
KEYWORDS
ABSTRACT
Introduction: Despite the progress which has been made in the diagnosis and treatment of lung cancer, it is still one of the main causes of death in both men and women. The introduction of new therapeutic modalities did not improve the 5-year survival results of lung cancer patients. The Lublin Voivodeship is a sparsely-inhabited area with little urbanization and a population of about 2.2 million people. Only 46.8% of its citizens live in the towns, while the national average is 61.9%. Objectives: The aim of the study was to compare the differences in the periods of time and reasons for delay in diagnosis and initiation of treatment of lung cancer among patients who are inhabitants of the rural and urban regions of Lublin Voivodeship, and who were consulted in Thoracic Surgery Department. Materials and methods: 300 lung cancer patients who were consulted in the Thoracic Surgery Outpatient Clinic or who were hospitalized in the Department of Thoracic Surgery in the period between 2 January 2010 – 7 January 2011 were included in the study. Delays were calculated for two periods of time: 1) time from the first signs of the disease to the first medical examination; 2) the time from the first visit to a doctor to the start of treatment, or disqualification from the causative treatment. The time of the first delay for the urban and rural populations was similar and ranged from 2-37 weeks and 2-23 weeks, respectively. Lack of time and disregard of signs of disease were the most commonly reasons given for the first delay among rural residents. The urban population indicated fear and lack of time as the main reasons of delay. Assessment of the second reason for delay was possible thanks to a specially designed research protocol which gathered the main reasons of delay in several subgroups that enabled their statistical evaluation. The length of second period was similar for both populations. Results: There were no significant differences in the length of the time of delay between the two assessed groups. In both groups, delays dependent on poor healthcare access were similar. Among rural inhabitants, the most often reasons of delay were waiting for hospital admission and re-bronchoscopy. In the urban population, the most common reasons for delay were waiting for hospitalization and CT procedure. Conclusions: The results of the presented research allowed the following conclusions to be drawn: between the two assessed groups there were no differences in the length of the time of delay; 2) delays in diagnosis and treatment were too long for the patients and could affect the severity of the disease and final prognosis; 3) there is a need for intensification of information campaigns on lung cancer in order to reduce the delays dependent on patients, and to improve the cooperation of family doctors, pulmonologists, thoracic surgeons and oncologists.
 
REFERENCES (36)
1.
Jemal A, Siegel R, Xu J, Ward E. Cancer statistics. CA Cancer J Clin 2010; 60:277-300.
 
2.
Annakkaya AN, Arbak P, Balbay O, Birgin C, Erbas M, Bulut I. Effect of symptom-to-treatment interval on prognosis in lung cancer. Tumori. 2007; 93: 61-67.
 
3.
Petty TL. The early diagnosis of lung cancer. Dis Mon. 2001; 47: 204–264.
 
4.
Radzikowska E, Roszkowski K, Głaz P. Lung cancer – diagnosis and therapy delay. Pneumonol Alergol Pol. 2001; 69(11-12): 600-610.
 
5.
Carbone P. Lung Cancer: Early Events, Early Interventions: Conference Summary for the 46th Annual Thomas L. Petty Aspen Lung Conference. Chest. 2004; 125(5): 167–72.
 
6.
O’Rourke N, Edwards R. Lung cancer treatment waiting times and tumour growth. Clin Oncol. (R Coll Radiol) 2000; 12(3): 141-144.
 
7.
Corner J., Hopkinson J. Roffe L. Experience of health changes and reasons for delay in seeking care: a UK study of the months prior to diagnosis of lung cancer. Soc Sci Med. 2006; 62: 1381-1391.
 
8.
Ozlu T, Bulbul Y, Oztuna F, Can G. Time course from first symptom to the treatment of lung cancer in the Eastern Black Sea Region of Turkey. Med Princ Pract. 2004; 13: 211-214.
 
9.
Liberman M, Liberman D, Sampalis JS, Mulder DS. Delays to surgery in non-small-cell lung cancer. Can J Surg. 2006; 49: 31-36.
 
10.
Żuchowska-Vogelgesang B. Analiza przyczyn opóźnionego leczenia chorych na nowotwory złośliwe. Pol Tyg Lek. 1974; 29: 1211-1213.
 
11.
Tod AM, Craven J, Allmark P. Diagnostic delay in lung cancer: a qualitative study. J Adv Nurs. 2008; 61(3): 336-43.
 
12.
Hamilton W, Peters TJ, Round A, Sharp D. What are the clinical features of lung cancer before the diagnosis is made? A population based casecontrol study. Thorax. 2005; 60: 1059-1065.
 
13.
Quarterman RL, McMillan A, Ratcliffe MB, Block MI. Effect of preoperative delay on prognosis for patients with early stage nonsmall cell lung cancer. J Thorac Cardiovasc Surg. 2003; 125(1): 108-13.
 
14.
Koyi H, Hillerdal G, Branden E. Patient’s and doctors’ delays in the diagnosis of chest tumors. Lung Cancer. 2002; 35: 53-57.
 
15.
Yilmaz A, Damadoglu E, Salturk C, Okur E, Tuncer LY, Halezeroglu S. Delays in the diagnosis and treatment of primary lung cancer: are longer delays associated with advanced pathological stage?. Ups J Med Sci. 2008; 113: 287-296.
 
16.
Olsson JK, Schultz EM, Gould MK. Timeliness of care in patients with lung cancer: a systematic review. Thorax. 2009; 64: 749-775.
 
17.
Jensen AR, Mainz J, Overgaard J. Impact of delay on diagnosis and treatment of primary lung cancer. Acta Oncol. 2002; 41(2): 147-52.
 
18.
Pawlicki M, Rachtan J, Żuchowska B. Ocena przyczyn opóźnionego leczenia chorych na nowotwory złośliwe. Nowotwory 1989; 39: 31-6.
 
19.
Chandra S, Mohan A, Guleria R, Singh V, Yadav P. Delays during the diagnostic evaluation and treatment of lung cancer. Asian Pac J Cancer Prev. 2009; 10: 453-456.
 
20.
Brocken P, Kiers BA, Looijen-Salamon MG, Dekhuijzen PN, Smitsvan der Graaf C, Peters-Bax L, de Geus-Oei LF, van der Heijden HF. Timeliness of lung cancer diagnosis and treatment in a rapid outpatient diagnostic program with combined FDG-PET and contrast enhanced CT scanning. Lung Cancer. 2011; 21.
 
21.
Yorio JT, Xie Y, Yan J, Gerber DE. Lung cancer diagnostic and treatment intervals in the United States: a health care disparity? J Thorac Oncol. 2009; 4(11): 1322-30.
 
22.
Tromp DM, Brouha XD, Hordijk GJ, Winnubst JA, de Leeuw JR. Patient factors associated with delay in primary care among patients with head and neck carcinoma: a case-series analysis. Fam Pract. 2005; 22: 554-559.
 
23.
Bozcuk H, Martin C. Does treatment delay affect survival in non-small cell lung cancer? A retrospective analysis from a single UK centre. Lung Cancer. 2001; 34(2): 243-52.
 
24.
Brocken P, Prins JB, Dekhuijzen PNR, Van der Heijden HFM. The faster the better? – a systematic review on distress in the diagnostic phase of suspected cancer, and the influence of rapid diagnostic pathways. Psycho-Oncology. 2011: 20.
 
25.
Kern KA. Medicolegal analysis of the delayed diagnosis of cancer in 338 cases in the United States. Arch Surg. 1994; 129: 397-403.
 
26.
Antkowiak JG. Regal AM, Takita H. Bronchogenic carcinoma in patients under age 40 Ann Thorac Surg. 1989; 47: 391-393.
 
27.
Bourke w, Milstein d, Giura R. Lung cancer in young adults. Chest. 1992; 102: 1723-1729.
 
28.
Pawlicki M, Rysz B. Badania nad przyczynami opóźnień w rozpoczęciu leczenia na nowotwory złośliwe. Nowotwory 2001; 51(5): 494-498.
 
29.
Salomaa ER, Sallinen S, Hiekkanen H, Liippo K. Delays in the diagnosis and treatment of lung cancer. Chest. 2005; 128: 2282-2288.
 
30.
Silva PP, Pereira JR, Ikari FK, Minamoto H. Lung cancer and the delay in diagnosis: analysis of 300 cases. Rev Assoc Med Bras. 1992; 38: 145-9.
 
31.
G.I.V.I.O. (Interdisciplinary Group for Cancer Evaluation), Author A. Diagnosis and first-line treatment of patients with lung cancer in Italian general hospitals. Tumori. 1989; 75: 163-167.
 
32.
Valdés S, García E, Pérez H, Hernández M. Length of diagnostic delay in patients with non-small-cell lung cancer. MEDICC Rev. 2010; 12(1): 29-32.
 
33.
Myrdal G, Lambe M, Hillerdal G, et al. Effect of delays on prognosis in patients with non-small cell lung cancer. Thorax. 2004; 59: 45-49.
 
34.
Corner J, Hopkinson J, Fitzsimmons D, Barclay S, Muers M. Is late diagnosis of lung cancer inevitable? Interview study of patients’ recollections of symptoms before diagnosis. Thorax. 2005; 60: 314-319.
 
35.
Buccheri G, Ferrigno D. Lung cancer: clinical presentation and specialist referral time. Eur Respir J. 2004; 24: 898-904.
 
36.
Bjerager M, Palshof T, Dahl R, Vedsted P, Olesen F. Delay in diagnosis of lung cancer in general practice. Br J Gen Pract. 2006; 569(532): 863-868.
 
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ISSN:1232-1966
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