Kudjawu Yao Cyril, Chatellier Gilles, Decool Elsa, de Maria Florence, Beltzer Nathalie, Grémy Isabelle, Meyer Guy, Eilstein Daniel
Institut de veille sanitaire, Département des maladies chroniques et traumatismes, 12 rue du val d'Osne, 94414 Saint-Maurice, France.
Assistance publique des hôpitaux de Paris, Unité d'épidémiologie et de recherche clinique, INSERM CIC1418, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75908 Paris cedex 15, France.
Lung Cancer. 2016 May;95:44-50. doi: 10.1016/j.lungcan.2016.02.016. Epub 2016 Mar 2.
Time-to-treatment of cancer is becoming a serious political and social issue. A greater understanding of the timeframes involved in cancer care is needed to reduce inequalities in access to care caused by delays.
To describe time delays in each phase of lung cancer treatment after bronchoscopy.
Using the international classification of diseases and medical procedures codes, from national hospital discharge database we selected patients newly diagnosed for Lung cancer in 2009-2010 who had undergone treatment.
We included 14,596 patients. Median times from bronchoscopy to 1) neo-adjuvant chemotherapy and to surgery in patients with surgical pathway were 34d (Q25=22; Q75=47) and 44d (Q25=26; Q75=82), respectively, 2) chemotherapy and to radiotherapy in patients with non-surgical pathway, were 33d (Q25=22; Q75=49) and 88d (Q25=46; Q75=162) respectively, 3) first treatment irrespective of pathway and treatment combination was 34d (Q25=22; Q75=50). Time to first treatment was significantly higher with age and with the status of the first care center. It was longer in most northern regions and in overseas districts and shorter in southern and eastern regions of the country.
To our knowledge, this is the first study based on medico-administrative database describing time to first treatment after bronchoscopy in patients suffering from lung cancer in France. It could inform decision-making on guidelines on times to access lung cancer treatment.
癌症治疗时机正成为一个严重的政治和社会问题。需要更深入了解癌症治疗过程中的时间框架,以减少因延误导致的医疗服务获取不平等现象。
描述支气管镜检查后肺癌治疗各阶段的时间延迟情况。
利用国际疾病分类和医疗程序编码,从国家医院出院数据库中选取2009 - 2010年新诊断为肺癌且接受过治疗的患者。
我们纳入了14596名患者。从支气管镜检查到1)手术路径患者的新辅助化疗和手术的中位时间分别为34天(Q25 = 22;Q75 = 47)和44天(Q25 = 26;Q75 = 82),2)非手术路径患者的化疗和放疗的中位时间分别为33天(Q25 = 22;Q75 = 49)和88天(Q25 = 46;Q75 = 162),3)无论治疗路径和治疗组合如何,首次治疗的中位时间为34天(Q25 = 22;Q75 = 50)。首次治疗时间随年龄和首诊中心状况显著升高。在该国大多数北部地区和海外地区较长,而在南部和东部地区较短。
据我们所知,这是第一项基于医疗行政数据库描述法国肺癌患者支气管镜检查后首次治疗时间的研究。它可为肺癌治疗获取时间指南的决策提供参考。