Timely and appropriate diagnosis, treatment and ongoing care for lung cancer requires complex multidisciplinary care. Although national guidelines are available for management of lung cancer1,2, variations in timeliness of access to cancer care in Australia have been documented3.
Optimal timeframes as per national guidelines are:
The specialist appointment should take place within 2 weeks of initial General Practitioner (GP) referral.
The time from initial referral-to-initial treatment should be no more than 6 weeks.
We explored the timeliness of workup and treatment of patients in ACT with newly diagnosed lung cancers including mesotheliomas in compliance with national guidelines and the factors associated with second-line delays in their management.
A retrospective analysis that involved identifying 100 consecutive eligible cases with thoracic malignancies discussed at multidisciplinary meetings (MDM) in the last one calendar year.
Time from initial referral-to-first specialist clinic appointment in 2 weeks or less was achieved for 65% of the patients with a median of 2 weeks. However, time from initial referral-to-first treatment was achieved for only 33% patients with a median of 9 weeks. Of the patients with treatment delays of more than 6 weeks, 69% were being treated with curative intent, 41% were from rural areas while 38% were complicated enough to be discussed at multiple MDMs. Most delays were associated with obtaining tissue diagnosis with an average time from first Computed Tomography (CT) scan to tissue diagnosis of 8 weeks.
Significant delays exist for patients in ACT with newly diagnosed thoracic malignancies at various stages of their management including diagnosis and treatment. More incidences of delays were associated with early cancer requiring surgical resection, and complex patients requiring multiple MDM discussions. Ongoing efforts are needed to understand these delays to improve timeliness of patients receiving cancer care as per national guidelines.