Patterns of care and emergency presentations for people with non-small cell lung cancer in New South Wales, Australia: A population-based study
| Autor: | Sarsha Yap, David Goldsbury, Mei Ling Yap, Dianne L. O'Connell, Nicole Rankin, Marianne Weber, Susan Yuill, Karen Canfell |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Emergency Medical Services Cancer Research medicine.medical_specialty Lung Neoplasms Databases Factual Comorbidity Disease 03 medical and health sciences 0302 clinical medicine Population Groups Carcinoma Non-Small-Cell Lung Health insurance Humans Medicine 030212 general & internal medicine Practice Patterns Physicians' Stage (cooking) Lung cancer Aged Aged 80 and over Patterns of care Cancer Type - Lung Cancer business.industry Australia Emergency department Middle Aged medicine.disease Cancer Control Survivorship and Outcomes Research - Resources and Infrastructure Population based study Oncology 030220 oncology & carcinogenesis Emergency medicine Female Non small cell business |
| Zdroj: | Lung Cancer. 122:171-179 |
| ISSN: | 0169-5002 |
| DOI: | 10.1016/j.lungcan.2018.06.006 |
| Popis: | Introduction Little is known about population-wide emergency presentations and patterns of care for people diagnosed with non-small cell lung cancer (NSCLC) in Australia. We examined patients’ characteristics associated with presenting to an emergency department around the time of diagnosis (“emergency presenters”), and receiving anti-cancer treatment within 12 months of diagnosis. Materials and Methods Participants in the 45 and Up Study who were newly diagnosed with NSCLC during 2006–2010 were included. We used linked data from population-wide health databases including Medicare and pharmaceutical claims, inpatient hospitalisations and emergency department presentations to follow participants to June 2014. Patients’ characteristics associated with being an emergency presenter and receiving any anti-cancer treatment were examined. Results A total of 647 NSCLC cases were included (58.6% male, median age 73 years). Emergency presenters (34.5% of cases) were more likely to have a high Charlson comorbidity index score, be an ex-smoker who had quit in the past 15 years and to be diagnosed with distant metastases. Almost all patients had visited their general practitioner ≥3 times in the 6 months prior to diagnosis. Nearly one-third (29.5%) of patients did not receive any anti-cancer treatment, however, there were no differences between emergency and non-emergency presenters in the likelihood of receiving treatment. Those less likely to be treated were older, had no private health insurance, and had unknown stage disease recorded. Conclusion Our results indicate the difficulties in diagnosing lung cancer at an early stage and inequities in NSCLC treatment. Future research should address opportunities to diagnose lung cancer earlier and to optimise treatment pathways. |
| Databáze: | OpenAIRE |
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