Understanding the delay in lung cancer diagnosis in the Taiwan healthcare system

http://www.ncbi.nlm.nih.gov/pubmed/22826351

Jpn J Clin Oncol. 2012 Jul 23. [Epub ahead of print]

Referral-free Health Care and Delay in Diagnosis for Lung Cancer Patients.

Hsieh VC, Wu TN, Liu SH, Shieh SH.

Source

1Department of Public Health, College of Public Health, China Medical University.

Abstract

OBJECTIVE:

Lung cancer is not only one of the most prevalent cancers but is also a lethal disease with a very low 5-year survival rate. Delay in diagnosis further reduces the chance of early treatment and worsens patients' survival. The purpose of this study was to understand the delay in the diagnosis of lung cancer under the healthcare system in Taiwan, and to identify the factors associated with it.

METHODS:

A total of 840 patients diagnosed with lung cancer who had completed or were undergoing cancer treatments were recruited from a medical center in central Taiwan from July 2007 to January 2011. Structured questionnaires were administered regarding demographic characteristics, factors associated with their time to diagnosis and the length of delay in days.

RESULTS:

Mean age was 62.68 years with 52.16 days to diagnosis on average. Number of hospital visits before confirmation of diagnosis differed significantly with the level of healthcare institution initially visited (P < 0.001). Compared with patients who had three or more hospital visits, patients who only visited two and one hospital(s) had a significant 34.91-day (95% confidence interval: 16.29-53.53) and 42.25-day (95% confidence interval: 20.76-63.76) reduction in their time to diagnosis (P < 0.001).

CONCLUSIONS:

As the number of hospital visits increased, the delay in diagnosis also increased. It is vital to shorten the time to diagnosis for lung cancer patients by limiting the number of medical visits and educating the public to restrict excessive use of medical resources and strengthen their trust in medical professionals.