The influence of patients’ experience of symptoms on delay in diagnosis of lung cancer: findings from the Victorian Component of International Cancer Benchmarking Project (ICBP) Module 4 — ASN Events
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The influence of patients’ experience of symptoms on delay in diagnosis of lung cancer: findings from the Victorian Component of International Cancer Benchmarking Project (ICBP) Module 4 (#32)

Victoria White 1 , Ashley Farrelly 1 , Kathryn Whitfield 2 , Nicola Quin 3 , David Weller 4 , Robert Thomas 5
  1. Cancer Council Victoria, Carlton, Vic, Australia
  2. Cancer Strategy & Development,, Victoria Department of Health, Melbourne, Victoria, Australia
  3. Cancer Council Victoria, Melbourne, VIC, Australia
  4. Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland
  5. Cancer Strategy & Development, , Victoria Department of Health, Melbourne, Victoria, Australia

OBJECTIVES:

ICBP-Module 4 examines causes for delay in diagnosis and treatment of four cancers. We use data from the Victorian component of ICBP to examine the influence of presenting symptoms on time to diagnosis and treatment for lung cancer (LC) patients. 

Method:

Cross sectional study of LC patients identified through Victorian Cancer Registry (VCR). VCR mailed invitation letter and questionnaire to patients 3- to 6-months post-diagnosis. Questionnaires assessed: symptoms and date, general practitioner (GP) appointments and dates, diagnosis date and treatment. Analyses determined median time between: symptom onset and first GP visit, GP visit to diagnosis; symptom onset to diagnosis.

RESULTS:

132 patients (response rate 47%) returned questionnaires (55% men; 24% 50-64 year: 66% 65-79 years; ever smoke: 85%). Although many patients reported LC symptoms, most (n=88) indicated their cancer was diagnosed while being investigated for another problem.  Common symptoms were: cough (17%), fatigue (14%) dyspnoea (9%), and haemoptysis (8%). Patients frequently attributed symptoms to causes of then LC.  Preliminary analyses found a median of: 7 days between symptom onset and GP appointment (range: 0-440); 30 days between GP appointment and diagnosis (range: 1-457), and 72 days between symptom onset to diagnosis (range: 1-365). Symptoms were related to delay with haemoptysis the shortest (median=1) and fatigue longest (median=35). Symptoms were related to time from GP visit to diagnosis: greatest for dyspnoea (median=62) and shortest for haemoptysis (median=4). 95% of patients had surgery: median 27 days post-diagnosis. The median symptom to treatment was 92 days and was related to symptom: haemoptysis: 68; dyspnoea: 87; cough: 161 and fatigue: 166.

CONCLUSIONS:

Perceived severity of LC symptoms contribute to delays in seeking treatment and diagnosis.  People at risk of LC need greater awareness of common LC symptoms. ICBP-Module 3 is investigating GPs response to LC symptoms to further understand delay in LC diagnosis. 

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