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Tytuł:
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Time to diagnosis and treatment of lung cancer: A systematic overview of risk factors, interventions and impact on patient outcomes.
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Autorzy:
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Zhang J; Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Victorian Comprehensive Cancer Centre, Melbourne, Australia. Electronic address: .
IJzerman MJ; Cancer Health Services Research Unit, Centre for Health Policy, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Australia.
Oberoi J; Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Victorian Comprehensive Cancer Centre, Melbourne, Australia.
Karnchanachari N; Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Victorian Comprehensive Cancer Centre, Melbourne, Australia; Primary Care Collaborative Cancer Clinical Trials Group (PC4), Melbourne, Australia.
Bergin RJ; Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Victorian Comprehensive Cancer Centre, Melbourne, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.
Franchini F; Cancer Health Services Research Unit, Centre for Health Policy, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Australia.
Druce P; Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Victorian Comprehensive Cancer Centre, Melbourne, Australia; Primary Care Collaborative Cancer Clinical Trials Group (PC4), Melbourne, Australia; The Central Clinical School, Monash University, Melbourne, Australia; The School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
Wang X; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, USA.
Emery JD; Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Victorian Comprehensive Cancer Centre, Melbourne, Australia; Primary Care Collaborative Cancer Clinical Trials Group (PC4), Melbourne, Australia.
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Źródło:
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Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2022 Apr; Vol. 166, pp. 27-39. Date of Electronic Publication: 2022 Jan 25.
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Typ publikacji:
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Journal Article; Review; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Limerick : Elsevier Scientific Publishers
Original Publication: Amsterdam, The Netherlands : Elsevier, c1985-
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MeSH Terms:
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Lung Neoplasms*/diagnosis
Lung Neoplasms*/therapy
Humans ; Risk Factors
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Contributed Indexing:
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Keywords: Delayed diagnosis; Lung neoplasms; Outcome assessment; Time-to-treatment
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Entry Date(s):
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Date Created: 20220213 Date Completed: 20220426 Latest Revision: 20220505
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Update Code:
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20240104
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DOI:
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10.1016/j.lungcan.2022.01.015
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PMID:
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35152171
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Over half of patients with lung cancer are diagnosed at a stage when curative treatment is not possible, suggesting an earlier diagnosis could improve outcomes. This comprehensive overview summarises the evidence on 1) times to diagnosis and treatment, 2) their impact on patient outcomes, 3) risk factors and 4) interventions to reduce time intervals, and 5) key methodological issues in such studies. Eligible articles were relevant systematic or scoping reviews and meta-analyses, searched via PubMed, Embase, Web of Science, and Cochrane Library; published from database inception to 6 August 2020 (PROSPERO identifier: CRD42020203530). A total of 18 systematic and scoping reviews were included. Times to diagnosis and treatment significantly varied and were often longer than recommended in international guidelines. Results regarding the impact of time intervals on survival or tumour stage indicated mixed associations (positive, negative, or no); in each review, however, more studies reported either no or negative association. Risk factors were considerable, categorized at the disease, patient, healthcare provider and system levels. Interventions including fast-access diagnosis programs, patient navigation and multidisciplinary strategies were effective in reducing times to diagnosis and treatment. Methodological issues included large variations in interval definitions and summary measures, lack of addressing an important potential source of bias-the "waiting time paradox"-and few studies of trends over time of these intervals. The current evidence indicates that patients with lung cancer experience diagnosis and treatment delays given guidelines' recommendations, but there are inconsistent findings about the association between times to diagnosis and treatment and patient outcomes. This is partially due to variations in definitions of time intervals, and limitations in analytic approaches that fail to account for a potential waiting time paradox. The identified risk factors and effective interventions demonstrate the potential for improvements in addressing diagnostic and treatment delays, regionally and globally.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
