A new study by Cancer Council NSW has revealed that over one in three lung cancer patients go to the emergency room around the time of diagnosis, highlighting the need for more research into early detection of lung cancer. The study also showed potential inequities in treatment, with patients who had no private health insurance shown to be less likely to receive treatment.
Analysing data from the Sax Institute’s 45 and Up Study, the study included 647 newly diagnosed non-small cell lung cancer (NSCLC) patients. NSCLC accounts for over 80% of all lung cancers. The study determined the proportion of lung cancer cases with an emergency presentation around the time of diagnosis, the types of initial treatments received after diagnosis, and patients’ characteristics associated with these outcomes.
“Our study found that 35% of patients presented to an emergency department up to one month before or in the month of diagnosis,” said Honorary Professor Dianne O’Connell, Senior Researcher at Cancer Council NSW.
“The proportion of patients in our study who were emergency presenters was similar to that reported in the UK,” Professor O’Connell added.
Emergency presenters had poorer health characteristics, including a high comorbidity score (i.e. other illnesses occurring in parallel to lung cancer). They were also more likely to be an ex-smoker who had quit in the past 15 years, and they were more likely to be to be diagnosed with advanced stage disease.
“This result shows that the pathways to a lung cancer diagnosis are complex. Often, patients have a number of other illnesses and non-specific symptoms, which leads to diagnostic difficulty and delays in diagnosis.
“For many lung cancer patients, poor survival is attributable to being diagnosed at an advanced stage,” Professor O’Connell said.
The study also looked at whether lung cancer patients had visited their doctor leading up to diagnosis, and what proportion of patients received treatment.
“92% of lung cancer patients had visited their GP at least 3 times in the 6 months prior to diagnosis, suggesting emergency presenters were not using the emergency department as their primary point of contact but were also using other healthcare channels prior to diagnosis,” Professor O’Connell said.
Importantly, nearly one in three patients did not receive any treatment after diagnosis. This is a concern:
“A number of previous studies in the past 20 years have shown this gap – essentially, nothing’s changed since 1996 in terms of someone’s likelihood of receiving treatment,” Professor O’Connell said.
“What our study adds to the picture, though, is that patients who had no private health insurance or were older at diagnosis were less likely to receive treatment, which indicates that there may be some inequities in lung cancer treatment.
“Future research should address opportunities to diagnose lung cancer earlier and to optimise treatment pathways – regardless of someone’s health insurance status,” Professor O’Connell concluded.
Source: Cancer Council NSW