Factors Influencing the Timeliness and Completeness of Appropriate Staging Investigations for Patients with Stage I–III Lung Cancer in Southeastern Ontario

(1) Background: Comprehensive and timely lung cancer (LC) staging is essential for prognosis and management. The Lung Diagnostic Assessment Program (LDAP) in Southeastern (SE) Ontario aims to provide rapid, guideline-concordant care for suspected LC patients. We evaluated factors affecting the compl...

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Main Authors: Shahad AlGhamdi, Nilah Ahimsadasan, Weidong Kong, Michael Brundage, Elizabeth A. Eisenhauer, Christopher M. Parker, Andrew Robinson, Andrew Giles, Geneviève C. Digby
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/31/10/453
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author Shahad AlGhamdi
Nilah Ahimsadasan
Weidong Kong
Michael Brundage
Elizabeth A. Eisenhauer
Christopher M. Parker
Andrew Robinson
Andrew Giles
Geneviève C. Digby
author_facet Shahad AlGhamdi
Nilah Ahimsadasan
Weidong Kong
Michael Brundage
Elizabeth A. Eisenhauer
Christopher M. Parker
Andrew Robinson
Andrew Giles
Geneviève C. Digby
author_sort Shahad AlGhamdi
collection DOAJ
description (1) Background: Comprehensive and timely lung cancer (LC) staging is essential for prognosis and management. The Lung Diagnostic Assessment Program (LDAP) in Southeastern (SE) Ontario aims to provide rapid, guideline-concordant care for suspected LC patients. We evaluated factors affecting the completeness and timeliness of staging for stage I–III LC patients in SE Ontario, including the impact of LDAP management. (2) Methods: This was a population-based retrospective cohort study using the LDAP database (January 2017–December 2019), linked with the Ontario Cancer Registry, to identify newly diagnosed LC patients. A Cox model approach identified variables associated with staging completeness and timeliness. (3) Results: Among 755 patients, 459 (60.8%) were managed through LDAP. Optimal staging was achieved in 596 patients (78.9%), 23 (3.0%) had alternative staging, and 136 (18.0%) had incomplete staging. In the adjusted analyses, LDAP management was associated with a higher likelihood of complete staging (OR 2.29, <i>p</i> < 0.0001) and faster staging completion (β = −18.53, <i>p</i> < 0.0001). Increased distance to PET centres was associated with a longer time to complete staging (β = 8.95 per 100 km, <i>p</i> = 0.0007), as was longer time to diagnosis (β = 21.63 per 30 days, <i>p</i> < 0.0001). (4) Conclusions: LDAP management in SE Ontario significantly improved staging completeness and shortened staging time for stage I–III LC patients.
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spelling doaj-art-985d74e9e34d41648d8c9f25fa03773b2025-08-20T02:11:09ZengMDPI AGCurrent Oncology1198-00521718-77292024-10-0131106073608410.3390/curroncol31100453Factors Influencing the Timeliness and Completeness of Appropriate Staging Investigations for Patients with Stage I–III Lung Cancer in Southeastern OntarioShahad AlGhamdi0Nilah Ahimsadasan1Weidong Kong2Michael Brundage3Elizabeth A. Eisenhauer4Christopher M. Parker5Andrew Robinson6Andrew Giles7Geneviève C. Digby8Department of Medicine, Division of Respirology, Queen’s University, Kingston, ON K7L 2V7, CanadaSchool of Medicine, Queen’s University, Kingston, ON K7L 2V7, CanadaCancer Care and Epidemiology Research Unit, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Oncology, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Oncology, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Medicine, Division of Respirology, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Oncology, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Surgery, Division of Thoracic surgery, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Medicine, Division of Respirology, Queen’s University, Kingston, ON K7L 2V7, Canada(1) Background: Comprehensive and timely lung cancer (LC) staging is essential for prognosis and management. The Lung Diagnostic Assessment Program (LDAP) in Southeastern (SE) Ontario aims to provide rapid, guideline-concordant care for suspected LC patients. We evaluated factors affecting the completeness and timeliness of staging for stage I–III LC patients in SE Ontario, including the impact of LDAP management. (2) Methods: This was a population-based retrospective cohort study using the LDAP database (January 2017–December 2019), linked with the Ontario Cancer Registry, to identify newly diagnosed LC patients. A Cox model approach identified variables associated with staging completeness and timeliness. (3) Results: Among 755 patients, 459 (60.8%) were managed through LDAP. Optimal staging was achieved in 596 patients (78.9%), 23 (3.0%) had alternative staging, and 136 (18.0%) had incomplete staging. In the adjusted analyses, LDAP management was associated with a higher likelihood of complete staging (OR 2.29, <i>p</i> < 0.0001) and faster staging completion (β = −18.53, <i>p</i> < 0.0001). Increased distance to PET centres was associated with a longer time to complete staging (β = 8.95 per 100 km, <i>p</i> = 0.0007), as was longer time to diagnosis (β = 21.63 per 30 days, <i>p</i> < 0.0001). (4) Conclusions: LDAP management in SE Ontario significantly improved staging completeness and shortened staging time for stage I–III LC patients.https://www.mdpi.com/1718-7729/31/10/453lung cancermultidisciplinary clinicstagingsystem barriers
spellingShingle Shahad AlGhamdi
Nilah Ahimsadasan
Weidong Kong
Michael Brundage
Elizabeth A. Eisenhauer
Christopher M. Parker
Andrew Robinson
Andrew Giles
Geneviève C. Digby
Factors Influencing the Timeliness and Completeness of Appropriate Staging Investigations for Patients with Stage I–III Lung Cancer in Southeastern Ontario
Current Oncology
lung cancer
multidisciplinary clinic
staging
system barriers
title Factors Influencing the Timeliness and Completeness of Appropriate Staging Investigations for Patients with Stage I–III Lung Cancer in Southeastern Ontario
title_full Factors Influencing the Timeliness and Completeness of Appropriate Staging Investigations for Patients with Stage I–III Lung Cancer in Southeastern Ontario
title_fullStr Factors Influencing the Timeliness and Completeness of Appropriate Staging Investigations for Patients with Stage I–III Lung Cancer in Southeastern Ontario
title_full_unstemmed Factors Influencing the Timeliness and Completeness of Appropriate Staging Investigations for Patients with Stage I–III Lung Cancer in Southeastern Ontario
title_short Factors Influencing the Timeliness and Completeness of Appropriate Staging Investigations for Patients with Stage I–III Lung Cancer in Southeastern Ontario
title_sort factors influencing the timeliness and completeness of appropriate staging investigations for patients with stage i iii lung cancer in southeastern ontario
topic lung cancer
multidisciplinary clinic
staging
system barriers
url https://www.mdpi.com/1718-7729/31/10/453
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