Source: Annual Congress 2009 - Epidemiology and management of lung cancer
Disease area: Thoracic oncology

Abstract

We wanted to study the effects of improvements in the diagnostic process introduced in Denmark during the last decade. All patients diagnosed at our centre in 2000 and 2008 were considered. After excluding 11 patients without verified pathology, we included 159 cases found in 2000 and 191 cases found in 2008. The fraction of female patients increased from 40% in 2000 to 52% in 2008 (p = 0.032, Fisher‘s Exact test). Median age was 67 years in 2000 against 69 years in 2008 (p = 0.067, Mann-Whitney test). In 2000 lung cancer was suspected from a chest X-ray in 158 out of the 159 patients (99.4%). This fraction decreased to 83.2% in 2008 when 11.0% of the patients were suspected to have lung cancer due to other imaging techniques. Median time from suspicion to completion of diagnostics was 27 days in 2000 against 15 days in 2008 (p < 0,001, Mann-Whitney test). In 2000 70 % of the patients were treated by surgery, chemotherapy, and/or radiotherapy against 79 % in 2008 (p = 0.082, Fisher‘s Exact test). Median delay from suspicion to first day of treatment was 41 days in 2000 against 28 days in 2008 (p < 0,001, Mann-Whitney Test). The 5-years survival rate was 9.4 % for the patients diagnosed in 2000, while the 1-year survival rate was 32%, and the median survival from suspicion was 7.5 months. At the end of February 2009, we have estimated the 1-year survival rate for patients diagnosed in 2008 to be 40% and the median survival to be 8.6 months (Kaplan-Meier method). If these differences are confirmed after prolonged observation, the faster diagnostic process may have contributed to an improved short-term survival.

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N. C. Hansen, H. Dall Madsen (Odense, Denmark). A considerable reduction of the diagnostic delay from 2000 to 2008 has at most contributed to a modest improvement of survival in Danish lung cancer patients. Eur Respir J 2009; 34: Suppl. 53, 4686

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