Delay in Acceptance of a Radiology-Initiated Notification for Lung Cancer Leads to Increased Wait Times for Treatment

Student Researcher:
Yasmin Valji

Supervisor / Principle Investigator:
Dr. Ken Stewart

Additional Authors:
Dr. Ashley Gillson
James Veenstra

MD Class of 2021


Introduction: Minimizing the interval between detection and treatment of lung cancer is important to improve survival and avoid upstaging. A radiology-initiated notification (DI) process was developed to address this problem.

Hypothesis: There is no difference in timeliness from CT to treatment and upstaging comparing patients involved in DI group vs. standard referral. Patients with a chest CT scan suspicious for lung cancer were referred to the Alberta Thoracic Oncology Program (ATOP).

Methods: Group A (n=891) were patients from CT ordering providers who agreed to ATOP organizing rapid assessment, while Group B (N=74) initially declined but were referred back at a later date. The time points between initial CT scan and date of referral, consultation, oncology referral and surgery were recorded. As well, clinical and pathological stage of lung cancer were evaluated.

Results: A significant difference in times for CT to referral, CT to consult, CT to oncology referral was determined, however CT to surgery comparison did not reach significance. When comparing initial CT staging to pathology staging, there was no statistical difference between subset analyses of the two groups. This may have been related to a small sample size sizes (n= 49 for group A, n= 27 group B).

Conclusion: The results of the study show that declining a Diagnostic Imaging notification process leads to increased wait times for patients suspected of having lung cancer from initial CT chest to treatment. This study did not demonstrate upstaging of lung cancer but results may be limited by small sample size.