Oral Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

How long are the intervals to diagnosis and treatment in NSW patients with lung cancer? A patient-reported perspective (#78)

Ashanya Malalasekera 1 2 , Natalie Stefanic 1 , Haryana Dhillon 1 , Prunella Blinman 2 , Mario D'Souza 3 , Steven Kao 4 , Janette Vardy 1 2
  1. University of Sydney, Sydney, NSW
  2. Concord Cancer Centre, Concord West, NSW, Australia
  3. Sydney Local Health DIstrict, Sydney
  4. Chris O'Brien Lifehouse, Sydney


Earlier access to specialist care can improve cancer survival rates. Regional patients may experience prolonged times to cancer diagnosis and treatment, but NSW data are lacking. The intervals from patient presentation to first GP referral to specialist and from GP referral to treatment start, are defined as the Primary (PC) and Secondary Care (SC) Intervals, respectively. Time from presentation to diagnosis, and diagnosis to treatment, are the Diagnostic and Treatment Intervals, respectively.  The UK recommends patients transition from PC to SC within 2 weeks and achieve this in 55-70% lung cancer cases. 1



We aimed to determine these intervals in a cohort of NSW lung cancer patients and compare regional and metropolitan patient data.



Design: cross-sectional, multi-site study using semi-structured interviews to construct time intervals, with dates verified from medical records.

Population: Patients within 12 months of a diagnosis of NSCLC/SCLC. The accrual target was 100 patients.

Analysis: Descriptive statistics were used to report each interval. Difference in the means for regional and metropolitan patients was assessed using a t-test.



Four NSW cancer centres participated, referring 107 patients (35% regional, 65% metropolitan). The majority had Stage IV (65%) NSCLC (80%), were male (60%), Caucasian (86%), history of smoking (57%), ECOG performance status ≤1 (93%) and received systemic therapy (56%). The median Diagnostic Interval was 25 days (range 0–564, SD 73.5) and Treatment Interval was 22.5 days (range 0 -120, SD 21.1).  The large majority (87%) of patients were seen by a specialist within two weeks of GP referral. There were no significant differences in any intervals for regional versus metropolitan patients.



NSW is achieving a high throughput of patients with suspected lung cancer in recommended timeframes of within two weeks.   All intervals for NSW lung cancer patients were comparable between regional and metropolitan sites.

  1. Lewis NR, Le Jeune I, Baldwin DR. Under utilisation of the 2-week wait initiative for lung cancer by primary care and its effect on the urgent referral pathway. Br J Cancer 2005; 93(8): 905–908.