A cross-sectional study on different time intervals from the appreciation of symptoms to final diagnosis in inoperable primary lung cancer: An Eastern Indian experience

Chatterjee, Suman; Misra, Swapnendu; Das, Ira; Chakraborty, Ritam; Kaushik, Sushmita; Kundu, Soumi; Jana, Pulak Kumar

doi:10.4103/2320-8775.183837

Cited by 3 publications

(1 citation statement)

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“…Approach delay-defined when the approach interval was 30 days or more Based on a study by Chatterjee et al on time intervals in lung cancer diagnosis, the approach interval from symptom onset to first doctor visit was about 60 days. 10 All patients with cough lasting for more than 2 weeks are considered presumptive pulmonary tuberculosis (PTB) as per the national policy, and because 60 days is a long time delay, we opted 1 month or more as an approach delay. 9 The factors studied included age, sex, education level, urban versus rural residence, occupation, smoking status, concurrent COPD, history of tuberculosis, and a family history of lung cancer.…”

Section: Questionnaire and Data Collectionmentioning

confidence: 99%

Delays in Lung Cancer Diagnosis: Observations from a Tertiary Care Centre in Kerala, India

Yohannan

Narayan

Venugopal

et al. 2023

South Asian J Cancer

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Introduction Timely diagnosis of lung cancer is critical because treatment outcomes correspond to the stage of disease. This study identified patient and physician determined reasons for diagnostic delays. Methods This was an observational cross-sectional study, conducted at a tertiary care institution in South India, for 12 months. From 207 consecutively selected patients, with a presumptive lung cancer diagnosis, 150 were enrolled utilizing a prefixed questionnaire. The time intervals from appreciation of initial respiratory symptoms to a final tissue diagnosis were defined sequentially as approach interval, referral interval, and diagnostic interval and factors causing delay in each interval were identified. Results In a state with 100% literacy, the mean time to approach a doctor was 8 weeks (range: 0–336 days; SD: 7.95) with a delay seen in 52% of the study group. Referring a suspect lung cancer diagnosis to a specialist, took an average of 4.98 weeks (range: 1–26 weeks; SD: 5.64) with referral delays in 47.3% of patients. The mean diagnostic interval was 9.21 days (range: 3–41 days; SD: 7.18) and 16.7% of cases had diagnostic delays in spite of a definite procedure. Conclusion In a tuberculosis endemic location, empirical treatment with anti-tuberculosis therapy and prolonged antibiotic courses without serially monitoring the course of disease are responsible for referral delays. Also, 88.2% of the total females studied, presented late due to family and work pressures, fear of being stigmatized and being on prolonged home remedies. A wider dissemination and awareness on lung cancer are needed especially among females. A low threshold to reinvestigate and an early referral to a pulmonary or lung cancer specialist, when expected clinicoradiological improvement is lacking, in microbiologically negative tuberculosis should be highlighted.

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Section: Questionnaire and Data Collectionmentioning

confidence: 99%

Delays in Lung Cancer Diagnosis: Observations from a Tertiary Care Centre in Kerala, India

Yohannan

Narayan

Venugopal

et al. 2023

South Asian J Cancer

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Factors influencing the timeliness of care for patients with lung cancer in Bangladesh

Ansar

Lewis

McDonald

et al. 2023

BMC Health Serv Res

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Background This study explored the factors associated with timeliness of care in the healthcare seeking pathway among patients with lung cancer in Bangladesh. Methods A structured questionnaire was used for data collection from 418 patients with lung cancer through face-to-face interviews in three tertiary care hospitals. Log-rank tests were performed to test differences in the length of intervals between points in healthcare by socioeconomic characteristics and care seeking behaviours of the patients. Cox Proportional Hazard (PH) regression analysis was performed to identify the predictors of the intervals after adjustment for variations in other variables. Results A higher education level was associated significantly (p < 0.05) with a shorter interval between first contact with a healthcare provider (HCP) and diagnosis (median 81 days) and initiation of treatment (median 101 days). Higher monthly household income was associated significantly with a shorter time from first contact and diagnosis (median 91 days), onset of symptom and diagnosis (median 99 days), onset of symptom and treatment (median 122 days), and first contact with any HCP to treatment (median 111 days). Consulting with additional HCPs prior to diagnosis was associated significantly with longer intervals from first contact with any HCP and diagnosis (median 127 days), onset of symptom and diagnosis (median 154 days), onset of symptom and treatment (median 205 days), and first contact with any HCP to treatment (median 174 days). Consulting with informal HCPs was associated significantly with a longer time interval from symptom to treatment (median 171 days). Having more than one triggering symptom was associated significantly with a shorter interval between onset of symptoms and first contact with any HCP. Conclusion The predictors for timeliness of lung cancer care used in this study affected different intervals in the care seeking pathway. Higher education and income predicted shorter intervals whereas consulting informal healthcare providers and multiple providers were associated with longer intervals.

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Health systems influence on the pathways of care for lung cancer in low- and middle-income countries: a scoping review

2020

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Background: Globally, lung cancer is the most common cancer and cause of cancer-related deaths, responsible for nearly one in five deaths. Many health systems in low-and middle-income countries, including sub-Saharan Africa have weak organizational structure, which results in delayed lead time for lung cancer patient care continuum from diagnosis to palliative care. Aim: To map evidence on the health systems issues impacting on the delays in timely lung cancer care continuum from diagnosis to palliative care in LMICs, including sub-Saharan Africa. Methods: A scoping review was performed following the method of Arksey and O'Malley. Systematic searches were performed using EBSCOhost platform, a keyword search from the following electronic databases were conducted: PubMed/MEDLINE, Google Scholar, Science Direct, World Health Organization (WHO) library, and grey literature. The screening was guided by the inclusion and exclusion criteria. The quality of the included studies was determined by Mixed Method Appraisal Tool (MMAT). Results: A total of 2886 articles were screened, and 236 met the eligibility criteria for this scoping review study. Furthermore, 155 articles were also excluded following abstract screening. Eighty-one articles were selected for fullarticle screening by two researchers with 10 being selected for independent detailed data extraction for synthesis. These studies were also subjected to methodological quality assessment. All included studies were conducted in LMICs mostly Asia, the Middle East, and Latin America and published between January 2008 and June 2018. The ten included studies described at least one interval in lung cancer care. Conclusions: Reducing wait time across this care continuum is needed to improve easy access to healthcare, quality care, survival and patient outcomes, as many patients still face longer wait times for diagnosis and treatment of lung cancer than recommended in several healthcare settings. A multidisciplinary team approach will help to reduce wait time and ensure that all patients receive appropriate care. Interventions are needed to address delays in lung cancer care in LMICs. Health-care providers at all levels of care should be educated and equipped with skills to identify lung cancer symptoms and perform or refer for appropriate diagnostic tests.

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A cross-sectional study on different time intervals from the appreciation of symptoms to final diagnosis in inoperable primary lung cancer: An Eastern Indian experience

Cited by 3 publications

References 0 publications

Delays in Lung Cancer Diagnosis: Observations from a Tertiary Care Centre in Kerala, India

Delays in Lung Cancer Diagnosis: Observations from a Tertiary Care Centre in Kerala, India

Factors influencing the timeliness of care for patients with lung cancer in Bangladesh

Health systems influence on the pathways of care for lung cancer in low- and middle-income countries: a scoping review

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