Læknablaðið - 01.04.2017, Blaðsíða 17

LÆKNAblaðið 2017/103 177
R A N N S Ó K N
ENGLISH SUMMARY
Introduction: The aim of this study is to describe the characteristics of
patients who underwent a fast diagnostic track (FDT) due to suspected
lung cancer at Landspitali University Hospital, Iceland.
Material and methods: Hospital records were reviewed on background
characteristics, diagnosis, staging, waiting times and survival of all 550
patients (mean age 68.1 years, 57% female) that participated in the FDT
from February 1, 2008 to January 31, 2015. Adjusting for clinical charact-
eristics in a multivariate analysis, overall survival was compared for pati-
ents diagnosed with lung cancer within or outside the FDT in Iceland in
2014 (n=167, mean age 69.3 years, 61.7% female).
Results: Of the 550 FDT patients, 426 were diagnosed with lung cancer
(77.5%); 346 of the non-small cell type (NSCLC) (81.2%). The proportion
of patients receiving lung cancer diagnosis through the FDT increased
from 23.3% in 2008 to 47.9% in 2014 (p<0.001). The waiting time from
referral to diagnosis was 10 days median and 19 days from diagnosis
to initiation of treatment. More patients with advanced disease were
diagnosed outside the FDT (70.1% vs. 37.5%, p<0.05). When ad -
justed for age, sex, histology, stage at diagnosis and therapy, patients
diagnosed with lung cancer outside the FDT had higher risk of all-cause
mortality (HR 1.60; 95% CI: 0.95 – 2.71) although the difference was not
statistically significant.
Conclusion: An increasing proportion of lung cancer diagnosis in
Iceland is made through a fast diagnostic track with potential benefits
for patients. The waiting time from referral to diagnosis and treatment is
in line with international guidelines.
Fast diagnostic track for suspected lung cancer: A patient centered approach
Hrönn Harðardóttir1,2,3, Unnur A. Valdimarsdóttir2,3,4,5, Tómas Guðbjartsson2,6, Andrés Sigvaldason1, Sigrún Helga Lund3, Thor Aspelund3,7,
Sif Hansdóttir1, Steinn Jónsson1,2
1Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland, 2Faculty of Medicine, University of Iceland, Reykjavik, Iceland, 3Center of Public Health, Uni-
versity of Iceland, Reykjavik, Iceland, 4Department of Epidemiology, Harvard T.H.Chan School of Public Health, Boston, 5Department of Medical Epidemiology and Biostatistics, Karol-
inska Institutet, Stockholm, Sweden, 6Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland, 7Icelandic Heart Association, Kopavogur, Iceland.
Key words: lung cancer, non-small cell lung cancer, diagnostic track, waiting times, survival.
Correspondence: Hrönn Harðardóttir, hronnh@landspitali.is
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