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Management and organisation of respiratory health care
P31 Do Lung Cancer Patients Get a Better Deal If They Present By Two Week Wait Pathway?
  1. E Nuttall,
  2. K Mitton,
  3. M Wilkoninson,
  4. G Jifon,
  5. A Ansari,
  6. S Bari
  1. Royal Lancaster Infirmary, Lancaster, Lancashire

Abstract

Introduction Introduction of one stop lung cancer[LC] clinics have shortened the patient journey of 2 week wait [2WW] referral patients to reach diagnosis and treatment however because of multiple referral sources, non 2 week [N2WW] patients follow a different journey. Our aim was to find out whether there is significant difference in patient outcome in these two groups in a multisite NHS Trust.

Method Between January 2008 & December 2011 all patients who had a radiological & or histological diagnosis (n=996) made in LCMDT were included in this study. Demography, time to diagnosis, time & number of deaths, staging & histology were compared.

Results In 2WW group 439 [Age 71(35–95)years, 177 female and In N2WW group 557 [Age 72(22–95), 232 female were compared. No significant difference in age, however significant difference were noticed in time to diagnosis [referral to diagnosis] 24.9 (0–167) in 2WW & 27.4(0–176) days in N2WW group [p=0.029]. 313 died in 2WW group and 451 in N2WW till June 2012. The time between date of referral to date of death was also significant between 2WW and N2WW group 258 [15–1328] days to 185[3–1271] days respectively (p=0.001)). In the 2WW group 62% [74%NSCLC, 15%SCLC, Others 10%] vs. 46% CLC 17% others 17%. 124(28%) of 2WW and 163(29%) of N2WW presented with metastatic disease [p=ns], 149(33.9%) of 2WW and 142(26%) of N2WW presented with T4 disease. Median PS was 1 and 2 respectively.

Conclusion The data suggests there is a significant difference between patient journey and outcome between two groups despite no significant difference in staging. Poor documentation and use of upgrading to 2WW made it difficult to find out why so many were under N2WW. Physicians are encouraged to review and alter patient pathway for N2WW group to ensure equal access to health care and appropriate outcome for all patients with LC diagnosis.

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