GPs in England are falling short of the recommended time from presentation to chest X-ray for symptomatic patients with suspected lung cancer, a study published in the British Journal of General Practice suggests.
The study included patients with a diagnosis of lung cancer recorded in the Clinical Practice Research Datalink between 1 April 2012 and 31 December 2015. Time between presenting to general practice with symptoms and having a chest X-ray were recorded. Further data were extracted from the national cancer registry and the Hospital Episode Statistics Diagnostic Imaging Dataset.
Patients with lung cancer who presented symptomatically in general practice in the year pre-diagnosis and who had a pre-diagnostic chest X-ray were included. Time from presentation to chest X-ray (presentation-test interval) was determined and intervals classified based on national guideline recommendations as concordant (≤14 days) or non-concordant (>14 days).
Variation in intervals was examined by age, sex, smoking status and deprivation.
Despite the recommended presentation and test interval of less than 14 days, of 2102 patients with lung cancer, the median presentation to test interval was 49 (interquartile range [IQR], 5-172) days. Of these, only 727 (35%) patients had presentation to test intervals of ≤14 days (median, 1 [IQR 0-6] day) and 1375 (65%) had intervals of >14 days (median, 128 [IQR, 52-231] days).
Intervals were 63 per cent longer among patients who smoked compared with non-smokers (P<.001 females waited per cent longer than males and intervals were for every years from age>
These findings highlight a potential missed diagnostic opportunity. The authors say the results could help guide initiatives aimed at improving timely lung cancer diagnosis.