It is more important now than ever to understand the factors that impact early detection and treatment of non-small cell lung cancer. The COVID-19 pandemic reduced access to preventive and diagnostic care, causing many Americans to delay cancer treatment. Researchers at the Washington University School of Medicine in St. Louis, Missouri sought to determine the association between delayed surgical treatment and oncologic outcomes among veterans with non-small cell lung cancer.
This retrospective cohort study was composed of 9,904 veteran participants with a mean age of 67.7 years. All participants had clinical stage I non-small cell lung cancer. Approximately half of the participants were active smokers. Treatment delay was measured from the date of diagnosis on CT scan to the date of surgical treatment. A multivariable logistic regression analysis was performed to determine the relationship between delayed surgical treatment and oncologic outcome.
Ultimately, it was found that 26.6% of study participants had a zero-day wait time between diagnosis and surgical treatment. In addition, 70% of participants underwent lobectomy, and 53.3% had a minimally invasive incision. At thirty-day follow-up, 2.1% of the participants had died, and 8.2% had been readmitted.
Further analysis revealed that participants who received treatment within 12 weeks of diagnosis had significantly better overall outcomes than those who chose to delay surgery. Black veterans of low socioeconomic means were found to be significantly more likely to delay surgical treatment.
The researchers concluded that veterans who delay surgical treatment for non-small cell lung cancer face an increased risk of cancer recurrence and lower survival rates. A call to action is made for targeted interventions that would improve veteran access to care and eliminate disparities in delayed surgical treatment of non-small cell lung cancer .
Source: Heiden, B. T., Eaton, D. B., Engelhardt, K. E., Chang, S. H., Yan, Y., Patel, M. R., Kreisel, D., Nava, R. G., Meyers, B. F., Kozower, B. D., & Puri, V. (2021). Analysis of Delayed Surgical Treatment and Oncologic Outcomes in Clinical Stage I Non-Small Cell Lung Cancer. JAMA Network Open, 4(5), e2111613. https://doi.org/10.1001/jamanetworkopen.2021.11613