In Norway, the likelihood of a patient experiencing a hospital emergency visit leading to a lung cancer diagnosis increased with older age, more advanced stage, and more comorbidities, according to study results published in the European Journal of Public Health.

Differences in survival exist among patients with lung cancer. Potential explanations include varying proportions of emergency presentations, delays in treatment, and unequal access to treatment. Therefore, researchers in Norway aimed to describe these patterns of care among patients with lung cancer by performing a case-mix-adjusted multivariable logistic regression on the odds of emergency presentation and access to surgery, radiotherapy, and systemic anticancer treatment. In addition, a multivariable quantile regression analyzed the time from diagnosis to first treatment.

Of the 5713 patients with lung cancer diagnosed between2015 and 2016, 37.9% (n=2164) had an emergency presentation before their diagnosis. Older age, more advanced stage, and more comorbidities were associated with higher odds of having an emergency presentation (P <.001) and lower odds of receiving any treatment (P <.001). After adjusting for case-mix, the researchers found that the waiting times to curative radiotherapy and systemic anticancer treatment were 12.1 days longer and 5.6 days shorter, respectively, compared with waiting time to surgery. Patients with regional disease experienced a 4.7-day shorter waiting time to curative radiotherapy compared with patients with localized disease. Patients with a high income had 22% reduced odds of having an emergency presentation, and 63% and 40% increased odds of receiving surgery and systemic anticancer treatment, respectively.


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“Public health awareness campaigns should aim to improve the health literacy throughout the Norwegian population to encourage earlier hospital attendance, diagnosis and possibly treatment,” the authors concluded.

Reference

Nilssen Y, Brustugun OT, Møller B. Factors associated with emergency-related diagnosis, time to treatment and type of treatment in 5713 lung cancer patients. Eur J  Public Health. Published online May 3, 2021. doi:10.1093/eurpub/ckab071