Time From Presentation To Pre-Diagnostic Chest X-Ray In Patients With Symptomatic Lung Cancer: A Cohort Study Using Electronic Patient Records From English Primary Care

BackgroundNational guidelines in England recommend prompt chest X-ray (within 14 days) in patients presenting in general practice with unexplained symptoms of possible lung cancer, including persistent cough, shortness of breath, or weight loss.AimTo examine tune to chest X-ray in symptomatic patients in English general practice before lung cancer diagnosis, and explore demographical variation.Design and settingRetrospective whorl study using routinely collected general practice, cancer registry, and imaging data from England.MethodPatients with lung cancer who presented symptomatically in general practice in the year pre-diagnosis and who had a pre-diagnostic chest X-ray were included. Time from presentation to chest X-ray (presentation-test interval) was determined and intervals classified based on national guideline ,,commendations as concordant (<= 14 days) or non-conowdant (>14 days). Venation in intervals was examined by age. sex. smoking status, and deprivation.ResultsIn a cohort of 2102 patients with lung cancer, the median presentation-test interval was 49 (interquartile range [IQR] 5-172) days. Of these, 727[35%] patients had presentation-test intervals of <= 14 days lmedran 1 [IOR 0-61day) and 1375 (65%) had presentation-test intervals of >14 days (median 128 fICIR 52-2311days). Intervals were longer among patients who smoke (equivalent to 63% longer than non-smokers; P< 0.001). older patients (equivalent to 7% longer for every 10 years from age 27; P = 0.013), and ferrates (equivalent to 12% longer than males; P= 0.016).ConclusionIn symptomatic primary care patients who underwent chest X-ray before lung cancer diagnosis. only 35% were tested within the timeframe recommended by national guidelines. Patients who smoke. older patients, and females experienced longer intervals. These findings could help guide initiatives aimed at improving timely lung cancer diagnosis.