Impact of delay on diagnosis and treatment of primary lung cancer

Lung cancer continues to be a devastating disease that defies nearly all the therapeutic endeavours to improve the 5-year survival. Survival is determined to a large extent by age, morphology and stage. Early presymptomatic detection by screening has as yet failed to demonstrate any effect of such programmes. At the moment, medical healthcare units invest a significant proportion of their resources to eliminating waiting times in diagnosis and treatment in order to improve outcome. The aim of this literature review is to investigate whether waiting times and delays have any bearing on prognosis and treatment. Specifically, the hypothesis is raised that longer delays are associated with poorer survival or more advanced stage disease and may explain the poorer survival rate. Large-scale cohort studies within well-defined catchment areas are required both to establish the prognostic impact of delays and to understand the natural progression of lung cancers.