The effect of timeliness of care on lung cancer survival

Detalhes bibliográficos
Autor(a) principal: Guerreiro, Teresa
Data de Publicação: 2023
Outros Autores: Mayer, Alexandra, Aguiar, Pedro, Araújo, António, Nunes, Carla
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/155123
Resumo: Publisher Copyright: © 2023 The Author(s).
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spelling The effect of timeliness of care on lung cancer survivala population-based approachlung cancerquality of caresurvivaltreatment timelinessMedicine(all)SDG 3 - Good Health and Well-beingPublisher Copyright: © 2023 The Author(s).Background: Timeliness of care is an important dimension of healthcare quality but it’s unclear whether it improves clinical outcomes in lung cancer (LC) patients. Objectives: This study aims to analyze treatment patterns, time-to-treatment (TTT) and the impact of treatment timeliness (TT) in overall survival (OS) of patients diagnosed with LC in 2009–2014 in a population-based registry from Southern Portugal. Materials and Methods: We estimated median TTT for overall population, treatment type and stage. The impact of treatment and TT on five-year OS was analyzed using the Kaplan-Meier method and Cox regression modelling to determine the hazard ratio (HR) of death associated with treatment and TT. Results: From the 11,308 cases diagnosed, 61.7% received treatment. Treatment rate decreased with increasing stage from 88% in stage I to 66.1% in stage IV. Overall median TTT was 49 days (IQR: 28–88) and 43.3% received TT. Surgery had a longer TTT than radiotherapy and systemic treatment. Patients in earlier stages had lower TT rates and longer TTT compared to more advanced, 24.7% and 80 days in stage I versus 51.3% and 42 days in stage IV (p < 0.0001). OS was 14.9% for total population and 19.6% and 7.1% for patients with and without treatment registered, respectively. TT had no observed impact on OS for stages I/II but a negative effect for stages III/IV. Relative to treated, the adjusted mortality risk was higher in untreated patients (HR = 2.240; 95%CI: 2.293–2.553). Contrary to treatment, TT had a negative impact on survival, with 11.3% in timely vs. 21.5% in untimely treated. Compared to untimely treated, the risk of death in TT patients was 46.6% higher (HR = 1.465; 95%CI: 1.381–1.555). Conclusions: LC survival is highly dependent on early diagnosis and adequate treatment. Time-to-treatment was longer than recommended for all treatment types but particularly for surgery. Overall TT results were paradoxical, as better survival was observed in patients untimely treated. The factors associated with TT were not possible to analyze and its impact on patient outcomes remains unclear. However, it is important to assess quality-of-care to improved LC management.Escola Nacional de Saúde Pública (ENSP)Comprehensive Health Research Centre (CHRC) - Pólo ENSPCentro de Investigação em Saúde Pública (CISP/PHRC)RUNGuerreiro, TeresaMayer, AlexandraAguiar, PedroAraújo, AntónioNunes, Carla2023-07-11T22:23:47Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/155123eng2214-9996PURE: 65998907https://doi.org/10.5334/aogh.3845info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:37:37Zoai:run.unl.pt:10362/155123Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:55:55.633205Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The effect of timeliness of care on lung cancer survival
a population-based approach
title The effect of timeliness of care on lung cancer survival
spellingShingle The effect of timeliness of care on lung cancer survival
Guerreiro, Teresa
lung cancer
quality of care
survival
treatment timeliness
Medicine(all)
SDG 3 - Good Health and Well-being
title_short The effect of timeliness of care on lung cancer survival
title_full The effect of timeliness of care on lung cancer survival
title_fullStr The effect of timeliness of care on lung cancer survival
title_full_unstemmed The effect of timeliness of care on lung cancer survival
title_sort The effect of timeliness of care on lung cancer survival
author Guerreiro, Teresa
author_facet Guerreiro, Teresa
Mayer, Alexandra
Aguiar, Pedro
Araújo, António
Nunes, Carla
author_role author
author2 Mayer, Alexandra
Aguiar, Pedro
Araújo, António
Nunes, Carla
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Escola Nacional de Saúde Pública (ENSP)
Comprehensive Health Research Centre (CHRC) - Pólo ENSP
Centro de Investigação em Saúde Pública (CISP/PHRC)
RUN
dc.contributor.author.fl_str_mv Guerreiro, Teresa
Mayer, Alexandra
Aguiar, Pedro
Araújo, António
Nunes, Carla
dc.subject.por.fl_str_mv lung cancer
quality of care
survival
treatment timeliness
Medicine(all)
SDG 3 - Good Health and Well-being
topic lung cancer
quality of care
survival
treatment timeliness
Medicine(all)
SDG 3 - Good Health and Well-being
description Publisher Copyright: © 2023 The Author(s).
publishDate 2023
dc.date.none.fl_str_mv 2023-07-11T22:23:47Z
2023
2023-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/155123
url http://hdl.handle.net/10362/155123
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2214-9996
PURE: 65998907
https://doi.org/10.5334/aogh.3845
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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