Pathways to diagnosis of non-small cell lung cancer

Given the limited evidence around diagnosis of non-small cell lung cancer (NSCLC), this descriptive cohort study set out to quantify general practitioner (GP) attendance, diagnostic imaging and common pathways to diagnosis in NSW, Australia. Linked data from the 45 and Up Study was used, from 2006-2012, identifying 894 patients. Of this, 60% had four or more GP attendances in the 3 months prior to the diagnosis of NSCLC and 56% had GP-ordered imaging (chest X-ray or CT). The two most common pathways to diagnosis, accounting for one in three people, included GP and lung specialist (respiratory physician or cardiothoracic surgeon) involvement. Of the 894 patients, 25% had an emergency hospital admission. For 14% of the cohort, an emergency hospital admission was the only event identified on their pathway to diagnosis. This study highlights the substantial proportion of people with NSCLC that are being diagnosed as an emergency, and the diagnostic delay occurring in primary care. Further research is needed on the barriers to recognition of lung cancer symptoms, and interventions to expedite the diagnosis in primary care. Read the full text