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Diagnostic timelines and self-reported symptoms of patients with lung and gastrointestinal cancers undergoing radiation therapy. Retrospective case control study

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Abstract

Background

Previous studies have found that patients with lung cancer report worse patient experience compared to other tumour groups. Reasons that may negatively impact patient experience include delays in diagnosis as well as inadequate symptom management. The purpose of this study was to compare the diagnostic timelines and symptom reports of patients with lung and gastrointestinal (GI) cancers.

Methods

This study included patients diagnosed with lung or GI cancers who attended a radiation oncology (RO) consultation and/or received radiation treatment between May and August 2019 at the Tom Baker Cancer Centre, Calgary, Alberta, Canada. Data collected included demographics, dates of diagnostic time points, and self-reported symptom scores across 3 time points. A descriptive analysis was completed, and the median number of days between time points was compared between tumour groups.

Results

Patients with lung cancer had longer diagnostic timelines compared to GI patients. The median number of days between the first investigative test and biopsy was 21 days longer for patients with lung cancer (p < 0.05). From RO consultation to the first treatment review appointment, 25% and 4% of lung and GI patients, respectively, reported worsening of symptoms. A greater proportion of lung patients reported worse symptom scores during treatment compared to GI patients. This varied by specific symptom.

Conclusions

Patients with lung cancer experienced delays in receiving a diagnosis and worse symptom burden during radiation therapy in this study. We identified potential targets to improve patient experience.

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Availability of data

De-identified data can be shared upon request.

Code availability

Analysis was performed using Microsoft Excel and RStudio v1.0.153.

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Funding

This study was supported by the Person-centered Radiation Oncology Service Enhancement (PROSE) programme.

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Authors and Affiliations

  1. Department of Oncology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada

    Demetra Yannitsos, Lisa Barbera, Abdulla Al-Rashdan & Petra Grendarova

  2. Tom Baker Cancer Centre, Calgary, Canada

    Demetra Yannitsos, Lisa Barbera, Abdulla Al-Rashdan & Petra Grendarova

Authors
  1. Demetra Yannitsos
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  2. Lisa Barbera
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  3. Abdulla Al-Rashdan
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  4. Petra Grendarova
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Contributions

All authors contributed equally to the conceptualization of the manuscript; DY drafted the manuscript, while LB, AR, and PG provided clinical input and editorial oversight. All authors provided critical appraisal of the manuscript and approve its submission.

Corresponding author

Correspondence to Demetra Yannitsos.

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Ethics approval

The Institutional Research Information Services Solution (IRISS) Health Research Ethics Board through the University of Calgary provided ethics approval: HREBA.CC-18–0588.0

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Not applicable.

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The authors declare no competing interests.

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Appendix

Appendix

Table 4 Study population cancer characteristics by levels of ESAS-r completion
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Yannitsos, D., Barbera, L., Al-Rashdan, A. et al. Diagnostic timelines and self-reported symptoms of patients with lung and gastrointestinal cancers undergoing radiation therapy. Retrospective case control study. Support Care Cancer 30, 1501–1509 (2022). https://doi.org/10.1007/s00520-021-06522-0

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  • DOI: https://doi.org/10.1007/s00520-021-06522-0

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