Implications of a negative bronchoscopy on waiting times to treatment for lung cancer patients: results of a prospective tracking study

Devbhandari, Mohan P.; Quennell, Pauline; Krysiak, Piotr; Shah, Rajesh; Jones, Mark T.
September 2008
European Journal of Cardio-Thoracic Surgery;Sep2008, Vol. 34 Issue 3, p479
Academic Journal
Abstract: Objective: To ascertain the causes of delays in treatment to all patients presenting to our centre with a working diagnosis of lung cancer. All were entered prospectively into a ‘tracking study’. Methods: Of 342 consecutive confirmed cases of newly diagnosed lung cancer presenting between September 2003 and December 2005, 193 were general practitioner referrals and 149 presented through casualty and internal referrals. The former group formed the basis of the study. Of GP referral patients, 92 had a positive diagnostic bronchoscopy (group Bronch+). Their waiting times were compared with 94 others with negative result (group Bronch−). For uniformity of comparison the non-GP referral patients were excluded from this study. Results: There were no significant differences in the age, clinical presentation or clinical staging of the two groups. Bronch+ had higher proportion of male patients (p =0.05). Bronch+ group had higher proportion of small cell and squamous cell carcinoma whereas Bronch− group had higher prevalence of adenocarcinoma (p =0.02). More patients in Bronch− underwent curative (36 vs 18, p =0.01) intent treatment. Though the median intervals (days) between the referral to first chest outpatient appointments were similar between the two groups (1 vs 1, p =0.89), the intervals from out-patient to decision-to-treat (33 vs 57, p =0.001) and decision-to-treat to treatment (8 vs 12, p =0.05) were significantly longer for Bronch− group. Overall the median referral to treatment interval for Bronch− was significantly longer compared to Bronch+ (45 vs 75, p =0.001). Most of these delays occurred in the intervals from outpatient appointments to decision-to-treat. Conclusions: A negative initial bronchoscopy in a suspected lung cancer patient implies a greater potential for excessive delays in diagnosis and treatment in spite of a greater chance of curative treatment. Most of the delay occurs in the interval from the outpatient appointment to decision-to-treat. Patients with negative bronchoscopy require a more concerted effort to achieve a timely diagnosis and treatment.


Related Articles

  • Management of Barrett's esophageal carcinoma. Miyazaki, Tatsuya; Inose, Takanori; Tanaka, Naritaka; Yokobori, Takehiko; Suzuki, Shigemasa; Ozawa, Daigo; Sohda, Makoto; Nakajima, Masanobu; Fukuchi, Minoru; Kato, Hiroyuki; Kuwano, Hiroyuki // Surgery Today;Apr2013, Vol. 43 Issue 4, p353 

    Barrett's esophagus (BE) is the premalignant lesion from which esophageal adenocarcinoma near the esophagogastric junction arises. The management of BE and the treatment of Barrett's esophageal adenocarcinoma (BEA) are important clinical issues in Europe and the United States. As the...

  • Comparison of endoscopic features of early-stage squamous cell lung cancer and histological findings. Konaka, C; Hirano, T; Kato, H; Furuse, K; Takada, M; Saito, Y; Monden, Y; Matsui, E; Watanabe, Y // British Journal of Cancer;7/1/99, Vol. 80 Issue 9, p1435 

    Seventy cases with early-stage central-type squamous cell carcinoma were treated surgically between 1984 and 1993 in seven participating institutes. We classified endoscopic features of early-stage central-type squamous cell carcinoma into three types (hypertrophic type, nodular type and...

  • LUNG CANCER DRUG MAY HELP TREAT ORAL CANCER.  // Journal of the American Dental Association (JADA);Feb2004, Vol. 135 Issue 2, p152 

    Reports on the possibility of using Gefitinib, a drug approved to treat advanced non-small-cell lung cancer in patients who have received chemotherapy, to treat oral cancer. Process by which the drug helps treat cancer; Effect of Gefitinib on patient response to radiotherapy in oropharyngeal...

  • Squamotous-type sarcomatoid carcinoma of the lung with rhabdomyosarcomatous components. Turk, Figen; Yuncu, Gokhan; Bir, Ferda; Ozturk, Gokhan; Ekinci, Yasin // Journal of Cancer Research & Therapeutics;Jan-Mar2012, Vol. 8 Issue 1, p148 

    Lung carcinosarcoma is an infrequently biphasic tumor composed of carcinomatous and sarcomatous components. It is divided into endobronchial (squamous-type) and peripheral (glandular type) categories. The carcinomatous component is usually a squamous carcinoma, and the sarcomatous component...

  • Minimally Invasive Esophagectomy in a Previously Pneumonectomized Patient. Petri, Roberto; Brizzolari, Marco; Sorrentino, Mario; Bassi, Flavio; Muzzi, Rodolfo; Zuccolo, Marco // Journal of Laparoendoscopic & Advanced Surgical Techniques;Sep2012, Vol. 22 Issue 7, p695 

    Introduction: Surgical resection represents the only therapeutic action having a radical intent for the treatment of resectable esophageal neoplasms. Minimally invasive esophagectomy for esophageal cancer is being more and more frequently performed. Few cases of esophagectomy after pneumonectomy...

  • Therapeutic decisionmaking in the molecular era. Blais, Normand // Oncology Exchange;Feb2014, Vol. 13 Issue 1, p16 

    Current treatment based algorithms for NSCLC are often derived from studies that were conducted prior to the extensive wealth of knowledge that was gained by subtyping lung cancer into distinct molecular entities. New studies are now helping to refine strategies for second-line approaches in...

  • Cisplatin benefit is predicted by immunohistochemical analysis of DNA repair proteins in squamous cell carcinoma but not adenocarcinoma: theranostic modeling by NSCLC constituent histological subclasses. Pierceall, W. E.; Olaussen, K. A.; Rousseau, V.; Brambilla, E.; Sprott, K. M.; Andre, F.; Pignon, J.-P.; Le Chevalier, T.; Pirker, R.; Jiang, C.; Filipits, M.; Chen, Y.; Kutok, J. L.; Weaver, D. T.; Ward, B. E.; Soria, J.-C. // Annals of Oncology;Sep2012, Vol. 23 Issue 9, p2245 

    Background Most non-small-cell lung cancer (NSCLC) patients receive cisplatin-based chemotherapy though clinical response is restricted to a subset of patients. DNA repair protein levels are possible surrogates for cisplatin-induced DNA adduct (and subsequent cell death) repair efficiency and...

  • DNA repair protein expression in resected NSCLC: a different predictive value for platinum benefit in adenocarcinoma versus squamous-cell carcinoma? Felip, E.; Martinez-Marti, A. // Annals of Oncology;Sep2012, Vol. 23 Issue 9, p2211 

    No abstract available.

  • Phase II study of carboplatin and pemetrexed in advanced non-squamous, non-small-cell lung cancer: Kyoto Thoracic Oncology Research Group Trial 0902. Kim, Young; Hirabayashi, Masataka; Togashi, Yosuke; Hirano, Katsuya; Tomii, Keisuke; Masago, Katsuhiro; Kaneda, Toshihiko; Yoshimatsu, Harukazu; Otsuka, Koujirou; Mio, Tadashi; Tomioka, Hiromi; Suzuki, Yujiro; Mishima, Michiaki // Cancer Chemotherapy & Pharmacology;Aug2012, Vol. 70 Issue 2, p271 

    Background: Subgroup analyses of randomized studies have consistently shown that pemetrexed is exclusively effective in non-small-cell lung cancer (NSCLC) other than squamous cell carcinoma and the combination of pemetrexed and platinum agents is recommended for first-line chemotherapy in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics