Barriers to timely lung cancer diagnosis and treatment in a Philippine tertiary hospital

Timeliness of care is crucial to optimize outcomes in lung cancer. In the Philippines, the causes of delays in lung cancer diagnosis and treatment have not yet been explored. We reviewed records of patients diagnosed with lung cancer in our institution between September 2017 and August 2019 after biopsy or resection of a pulmonary lesion. Time to specialist consultation, biopsy, cancer diagnosis, and treatment were measured and compared with standards set by the British Thoracic Society. Eighty patients were included in the analysis. The median time to pulmonology consult and biopsy was 5 and 18 days, respectively. Cancer diagnosis was made within 28 days for 48% of patients. Causes of delay include late pulmonology referral (21%), delayed biopsy (38%), need for repeat biopsy (24%), and performing outright resection (10%). Out of 25 patients who received systemic treatment, only four were treated within 28 days of their cancer diagnosis. Curative resection was delayed beyond 56 days for two out of four patients. Each step in the management of lung cancer is a potential cause for delay. This study revealed opportunities for improvement in multiple areas of care that can allow more patients to benefit from treatment.