Analysis of Diagnostic Delay and its Impact on Lung Cancer Survival: Results From the Spanish Thoracic Tumor Registry
Arch Bronconeumol. 2024 Oct:60 Suppl 2:S38-S45.
doi: 10.1016/j.arbres.2024.07.006.
Epub 2024 Jul 15.
[Article in
English,
Spanish]
Authors
Cristina Candal-Pedreira
1
, Alberto Ruano-Ravina
2
, Virginia Calvo de Juan
3
, Manuel Cobo
4
, Alexandra Cantero
4
, Delvys Rodríguez-Abreu
5
, Anna Estival
5
, Enric Carcereny
6
, Ainhoa Hernandez
6
, Rafael López Castro
7
, Andrea Medina
7
, Rosario García Campelo
8
, Manuel Fernández Bruno
8
, Reyes Barnabé
9
, Joaquim Bosch-Barrera
10
, Bartomeu Massutí
11
, Manuel Dómine
12
, Carlos Camps
13
, Ana Laura Ortega
14
, Mariano Provencio
15
Affiliations
- 1 Area of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Spanish Lung Cancer Group, Spain.
- 2 Area of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Spanish Lung Cancer Group, Spain. Electronic address: [email protected].
- 3 Spanish Lung Cancer Group, Spain; Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.
- 4 Spanish Lung Cancer Group, Spain; Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain.
- 5 Spanish Lung Cancer Group, Spain; Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
- 6 Spanish Lung Cancer Group, Spain; Institut Català D'Oncologia Badalona - Hospital Germans Trias i Pujol, B-ARGO, IGTP, Badalona, Spain.
- 7 Spanish Lung Cancer Group, Spain; Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
- 8 Spanish Lung Cancer Group, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain.
- 9 Spanish Lung Cancer Group, Spain; Hospital Universitario Virgen del Rocio, Sevilla, Spain.
- 10 Spanish Lung Cancer Group, Spain; Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta and Precision Oncology Group (OncoGIR-Pro), Institut d'Investigacions Biomèdiques de Girona (IDIBGI), Girona, Spain.
- 11 Spanish Lung Cancer Group, Spain; Hospital General Universitario Dr. Balmis de Alicante, Alicante, Spain.
- 12 Spanish Lung Cancer Group, Spain; Hospital Universitario Fundación Jiménez Díaz. IIS-FJD, Madrid, Spain.
- 13 Spanish Lung Cancer Group, Spain; Hospital General Universitario de Valencia, Valencia, Spain.
- 14 Spanish Lung Cancer Group, Spain; Hospital Universitario de Jaén, Jaén, Spain.
- 15 Spanish Lung Cancer Group, Spain.
Abstract
Background:
Early detection is crucial to improve lung cancer survival rates. Delays in diagnosis might negatively impact the prognosis of the disease. This study aims to analyze the diagnostic delay in lung cancer patients and describe if there is an association between delay and survival.
Methods:
The data source used was the Thoracic Tumor Registry of the Spanish Lung Cancer Group. This analysis was restricted to lung cancer cases with information on the first date of consultation by symptoms and date of diagnosis. The delay was calculated as the number of days between the two dates. A descriptive analysis was performed, and ordinal logistic regressions were fitted with delay as the dependent variable. Kaplan-Meier survival analysis and Cox regression were performed.
Results:
22,755 lung cancer cases were included. Never smokers were 1.16 (95%CI: 1.06-1.27) times more likely to register longer delay than smokers. Stage 0-I-II cases had a 3.09 (95%CI: 2.88-3.32) higher risk of longer delay compared to III-IV stages. Overall, 5-year survival rate after diagnosis was 23.64% (95%CI: 22.88-24.41). In those categorized as having the shortest delay 5-year survival was 17.67% (95%CI: 16.31-19.07) and in the extreme delay it was 32.98% (95%CI: 31.28-34.69) (p<0.001). Adjusted mortality risk was higher in those with the shortest delay (HR 1.36, CI95%: 1.30-1.43) in comparison with the extreme delay.
Conclusions:
Diagnostic delay is short among Spanish lung cancer patients, indicating a relatively quick diagnostic process. Extreme delays appear to be associated with higher survival rates, possibly attributed to slow-growing tumors, earlier stage at diagnosis or basically the natural history of this disease.
Keywords:
Diagnosis; Lung cancer; Lung neoplasms.
Copyright © 2024 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.
MeSH terms
-
Aged
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Aged, 80 and over
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Delayed Diagnosis*
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Female
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Humans
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Kaplan-Meier Estimate
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Lung Neoplasms* / diagnosis
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Lung Neoplasms* / mortality
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Male
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Middle Aged
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Neoplasm Staging
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Registries*
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Smoking / epidemiology
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Spain / epidemiology
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Survival Rate