THE IMPACT OF DELAYED DIAGNOSIS OF LUNG-CANCER ON THE STAGE AT THE TIME OF OPERATION

Objective: The purpose of this investigation was to study the correlat ion between diagnostic delay and the stage of the lung cancer at the t ime of operation. A second objective was to study differences in sympt oms between the patients grouped according to stage. Methods: A total of 172 patients consecutively admitted for surgery between 1 January 1 994 and 1 June 1995 at the Department of Thoracic and Cardiovascular S urgery of Rigshospitalet National Hospital of Denmark were included in the retrospective study. Two groups of patients were compared. one gr oup with good prognosis (patients in Stages I and II) and one group wi th poor prognosis (patients in Stages III and IV). The rims-spans stud ied were: (1) interval from the patient's perception of the first symp tom to operation: and (2) the time from first contact with the healthc are-system to operation. The median delay between the patient-groups w as compared using the Mann-Whitney U-test. To compare the symptoms whi ch brought the patients in contact with the healthcare-system, the chi (2)-test was used. Results: In the time interval between appearance of the first symptom and operation. a significantly shorter median delay was found for patients with Stages I and II compared to Stages III an d IV (P = 0.037). Concerning the interval from first contact with the healthcare system to operation a significantly shorter median delay wa s found for the group of patients in Stage I and II compared to the pa tients-group in Stake III and IV (P = 0.017). It was found that the ca ncer was an accidental finding, significantly more often in patients i n Stages I or II compared to patients in Stages III or IV (P = 0.0002) . Conclusions: A few months delay before final treatment of a non-smal l-cell lung cancer stems to have an impact on the perioperative stage of the cancer, and thereby on the patients prognosis. A screening of a symptomatic risk-group patients will result in recognition of early lu ng cancer. (C) 1997 Elsevier Science B.V.