Optimal lung cancer care pathways: a Tasmanian perspective

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Tasmania, Australia, has the second-highest lung cancer incidence rate (44.0/100,000) and a low 5-year survival rate (20%).
• Timely diagnosis and treatment are crucial for improving lung cancer patient outcomes.

Purpose of the Study:

• To map and compare patient transit timelines from referral to treatment against national care quality indicators (NCQI) and optimal care pathway (OCP) benchmarks in Tasmania.
• Identify delays in the lung cancer patient journey to inform quality improvement initiatives.

Main Methods:

• Retrospective study of 165 small cell and non-small cell lung cancer cases diagnosed between 2019-2022 at a Tasmanian tertiary hospital.
• Extracted key dates including GP referral, specialist appointments, diagnosis, staging, and treatment initiation from multidisciplinary team meeting minutes, medical records, and the ARIA Oncology-Information System.
• Benchmarked patient timelines against NCQI and OCP standards.

Main Results:

• 93% of patients saw a respiratory specialist within 14 days of GP referral, and 71% were diagnosed within 28 days, meeting current standards.
• Significant delays were observed in initiating treatment after diagnosis, with only 7% of patients meeting benchmarks for time to treatment.
• The mean patient age was 72 years, with 57% being male; 93% had non-small cell lung cancer.

Conclusions:

• While initial diagnostic timelines meet national standards, prolonged time to treatment presents a significant challenge in Tasmania.
• Addressing both patient-level and systemic factors is essential to improve clinical indicator outcomes and lung cancer care quality.
• Achieving current national benchmarks for lung cancer treatment initiation requires further investigation and targeted interventions.