A cross-sectional study on different time intervals from the appreciation of symptoms to final diagnosis in inoperable primary lung cancer: An Eastern Indian experience

Background: Lung cancer is the most commonly diagnosed and most common cause of death from cancer worldwide. Diagnostic delays continue to remain a common problem, and surgery could be offered in time in <5% of the cases. Aims and Objectives: Assessment of different time intervals from the appreciation of symptoms to final diagnosis and identify probable factors contributing to delay in those intervals. This study will be helpful to find out the obstacle in the lung cancer diagnosis. Settings and Design: Observational cross-sectional tertiary care hospital-based study. Materials and Methods: Fifty cases were collected consecutively according to inclusion and exclusion criteria and assessed based on prefixed questionnaires. Application interval, referral interval, tertiary center interval, and total time to diagnose were measured. Results: Among 50 cases, 36 cases (72%) were male and 14 cases (28%) were female. Mean age was 55.50 years (range 22–81; standard deviation [SD] 12.68). Squamous cell carcinoma was found more in male and adenocarcinoma in female group (Fisher's P 0.0250). Mean application interval mean was 92 days (range 23–210, SD 41.81), mean referral interval 39 days (range 2–160, SD 26.89), mean interval at tertiary center 15 days (range 5–40, SD 8.027), and total interval mean was 146 days (range 45–240, SD 47.33). Among total cases, application delay was in 38 (76%) cases and referral delay in 35 (70%) cases. Median application interval in delay group was 94 days, and in no delay group was 40 days. Among total cases, 35 (70%) were in referral delay group. There was mean referral interval of 50 days and 14 days, respectively among the referral delay and no delay groups. Conclusion: There was maximum delay in application interval. Awareness of lung cancer and level of education along with neglect of a cough as index symptom are the major factors causing application delay. Significant numbers of the patient were not advised computed tomography thorax at the appropriate time and instead received empirical anti-tubercular treatment causing referral delay.