Timeliness of care and prognosis in patients with lung cancer.

BACKGROUND: Timeliness of care is an important dimension of health care quality. The determining factors of less timely care and their influence on the survival of patients with lung cancer (LC) remain uncertain. AIMS: To analyse the delays in the diagnosis and treatment of LC in our health area, the factors associated with the timeliness of care and their possible relationship with the survival of these patients. METHODS: A retrospective study was conducted on all patients with a cytohistologically confirmed diagnosis of LC between 1 June 2005 and 31 May 2008. The time delays for consultation (specialist delay), diagnosis (diagnosis delay), and treatment (treatment delay), were analysed, as well as the factors associated with these delays and the influence of the timeliness of care on survival. RESULTS: A total of 307 cases were included (87 % males). The mean specialist delay was 53.6 days (median 35 days), diagnosis delay 31.5 days (median 18 days), treatment delay 23.5 days (median 14 days). The greater age of the patient and a more advanced stage were associated with a shorter specialist delay. Male sex, a more advanced stage, and poor general status were associated with a shorter treatment delay. The survival is longer in patients with a longer treatment delay. CONCLUSIONS: The delay in the diagnosis in our population seems to be excessively long. The greater the age, a more advanced tumour stage, male sex, and poor general health status are associated with shorter delays. A longer treatment delay is associated with a longer survival.

[Lung cancer in the Pontevedra health area: incidence, clinical presentation and survival]. / Cancer de pulmon en el area sanitaria de Pontevedra: incidencia, presentación clinica y supervivencia.

BACKGROUND: To describe the clinical and epidemiological characteristics, and survival of patients with lung cancer (LC) in the Pontevedra Health Area. METHODS: A retrospective observational study was conducted on all patients with a diagnosis of LC in the Pontevedra Hospital Complex (CHOP) health area over a three-year period. The data recorded included, age, gender, smoking history, comorbidity, functional status, diagnostic method, histology type, stage, treatment received, and survival. The patients were followed up for 3 years. RESULTS: A total of 358 cases of LC were included in the study, which gave a crude incidence rate adjusted to the standard European population of 37.33/100,000 inhabitants/year in males and 4.88/100,000 inhabitants/year in females. The large majority were males (87%). The mean age was 68.7 years, and 82% were smokers or ex-smokers. The most common histology type was epidermoid, with 35.2% of the cases. The diagnosis was made in stages III-B or IV in 79% of cases. Chemotherapy was the first treatment in 53% of the cases. Survival after the first year was 25%, which decreased to 4% at the third year. CONCLUSIONS: The incidence of LC in our health area continues to be mainly in male smokers, although the incidence in females and in people who never smoked is higher than in other populations in our country. It is diagnosed in the advance stages of the disease, and survival is poor.

Cáncer de pulmón en el área sanitaria de Pontevedra: incidencia, presentación clínica y supervivencia / Lung cancer in the Pontevedra health area: incidence, clinical presentation and survival

Fundamento. Describir las características clínicas, epidemiológicas y supervivencia de los pacientes con cáncer de pulmón (CP) en el área sanitaria de Pontevedra. Material y métodos. Se realizó un estudio observacional, retrospectivo, incluyendo todos los pacientes con diagnóstico de CP en el área sanitaria del Complexo Hospitalario de Pontevedra(CHOP), incluyendo todos los casos diagnosticados en un período de 3 años. De cada paciente se incluyeron edad, sexo, tabaquismo, comorbilidad, estado funcional, método diagnóstico, tipo histológico, estadio, tipo de tratamiento y supervivencia. Los pacientes fueron seguidos durante 3 años Resultados. Se incluyeron en el estudio un total de 358 casos de CP, lo cual supone una tasa cruda de incidencia ajustada a la población europea estándar de 37,33/100.000 habitantes/año en varones y de 4,88/100.000 habitantes/año en mujeres. El 87%fueron varones, de 68,7 años de edad media, el 82% fumadores o exfumadores. El tipo histológico más frecuente fue el epidermoide, con el 35,2% de los casos. En el 79% de los casos se realizó el diagnóstico en estadios III-B o IV. La quimioterapia fue el primer tratamiento en el 53% de los casos. La supervivencia al primer año es del 25%, que se reduce al 4% al tercer año. Conclusiones. La incidencia de CP en nuestra área sanitaria sigue predominando en varones fumadores, aunque la incidencia en el sexo femenino y en nunca fumadores es superior a otras poblaciones de nuestro entorno. El diagnóstico se lleva a cabo en fases avanzadas de la enfermedad y la supervivencia es pobre (AU)

Backgroud. To describe the clinical and epidemiological characteristics, and survival of patients with lung cancer (LC) in the Pontevedra Health Area. Methods. A retrospective observational study was conducted on all patients with a diagnosis of LC in the Pontevedra Hospital Complex (CHOP) health area over a three-year period. The data recorded included, age, gender, smoking history, comorbidity, functional status, diagnostic method, histology type, stage, treatment received, and survival. The patients were followed up for 3 years. Results. A total of 358 cases of LC were included in the study, which gave a crude incidence rate adjusted to the standard European population of 37.33/100,000 inhabitants/year in males and 4.88/100,000 inhabitants/year in females. The large majority were males (87%). The mean age was68.7 years, and 82% were smokers or ex-smokers. The most common histology type was epidermoid, with 35.2% of the cases. The diagnosis was made in stages III-B or IV in 79% of cases. Chemotherapy was the first treatment in 53% of the cases. Survival after the first year was 25%, which decreased to 4% at the third year. Conclusions. The incidence of LC in our health area continues to be mainly in male smokers, although the incidence in females and in people who never smoked is higher than in other populations in our country. It is diagnosed in the advance stages of the disease, and survival is poor (AU)