Neglected Occupational Risk Factors-A Contributor to Diagnostic Delays in Lung Cancer

For lung cancer, the total interval time to diagnosis (TITD) is very important. If not detected by the screening program, the actual guidelines emphasize the need for a short delay to assure the initiation of treatment before 2 months from the initial symptoms. In order to shorten TITD, the individual risk has to be properly assessed by the primary physician.

The assessment of the influence of the occupational exposure on the diagnostic delay-from the onset of symptoms to confirmed diagnosis-in a population of patients with lung cancer.

A total of 110 cases were recruited and were divided into two groups based on the individual assessment by an occupational physician.

There were 38 cases (34.55%) at high risk according to their occupational exposure and 72 controls. On average, the TITD was 3.41 +/-5.12 months. The TITD was significantly longer in the high-risk group (p = 0.03). A larger proportion cases had longer TITD: 55.17% of cases vs. 44.83% of controls (p = 0.006). In a multivariate analysis including covariates' age, sex, level of education, health literacy, number of packs-years, family history of cancer, and previous lung diseases associated with a high risk of lung cancer, the highest risk derived from the previous occupational exposure was the only variable statistically associated with TITD (OR = 10.57, 2.06-54.34, p = 0.01).

Awareness about the occupational risk in workers who are or have been exposed and in health providers could reduce the total interval time to diagnosis.