A comparison of the effect of time-to-treatment on survival according to economic status of lung cancer patients with chronic diseases

Abstract

Purpose: The topic of providing timely treatment to lung cancer patients with chronic diseases has not been widely examined. This study therefore aimed to investigate the association between time-to-treatment and five-year mortality in lung cancer patients with diabetes, hypertension, or dyslipidemia.Methods: The National Health Insurance elderly cohort data (2002-2019) were used. The participants were 2,023 lung cancer patients with diabetes, hypertension, or dyslipidemia who underwent surgery. The Cox proportional hazards model was used to analyze the impact of time-to-treatment for first cancer treatment on five-year mortality. The cut-off value for time-to-treatment was set at 30 days. Sub-group analysis was conducted according to the economic status and the level of comorbidities. Results: Compared with individuals who received their first treatment for lung cancer in less than 30 days from diagnosis, patients who received their treatment after 30 days showed a higher risk of five-year mortality (HR 1.328, 95% CI 1.077-1.639). This difference in mortality risk was magnified in individuals of lower economic status or with a higher level of comorbidities.Conclusion: Lung cancer patients with diabetes, hypertension, or dyslipidemia who received their first treatment for cancer 30 days after diagnosis were more associated with five-year mortality. It emphasizes the importance of avoiding delays in the treatment and management of lung cancer with chronic diseases.