Analyzing the Time From Discovery to Definitive Surgical Therapy for Lung Cancer Based on Referral Patterns

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Early-stage non-small cell lung cancer (NSCLC) surgery offers curative potential.
• Delays in diagnosis-to-surgery for NSCLC can increase patient mortality.
• Optimizing the patient referral pathway is crucial for timely NSCLC treatment.

Purpose of the Study:

• To investigate if initial referral to non-thoracic specialists delays definitive surgical treatment for NSCLC.
• To compare surgical wait times between patients referred directly to thoracic surgeons versus those seeing other specialists first.
• To analyze the impact of insurance type on NSCLC treatment timelines.

Main Methods:

• Retrospective review of 150+ NSCLC patients undergoing surgery between 2013-2016.
• Comparison of time from initial CT scan to surgical resection between referral groups.
• Secondary analysis of insurance status (private vs. Medicare/Medicaid) and patient upstaging.

Main Results:

• No significant difference in CT-to-surgery time was observed between referral groups (79.88 vs. 79.90 days).
• Patients with private insurance had significantly shorter CT-to-surgery times (66.05 days) than Medicare/Medicaid patients (86.99 days).
• Fewer private insurance patients were upstaged (22.9%) compared to Medicare/Medicaid patients (31.8%).

Conclusions:

• Referral pathway to non-thoracic specialists does not significantly impact NSCLC surgical timing.
• Insurance status is a significant factor affecting treatment delays, with private insurance patients experiencing faster care.
• Further investigation into healthcare access disparities for NSCLC patients is warranted.