Improvement of the timeliness to lung cancer diagnosis and treatment with the Rapid Access Lung Lesion Clinic in regional Australia.

Abstract

e13519 Background: The Rapid Access Lung Lesion Clinic (RALLC) was implemented to expedite the multidisciplinary diagnostic pathway of suspected lung cancer in a regional tertiary centre in Victoria, Australia. The aim of this study was to audit the performance of this clinic against the recommended timeframes of the Victorian Optimal Care Pathway for People with Lung Cancer. Methods: Data of all patients referred to the RALLC clinic between July 2017 and December 2021 was prospectively collected, and compared with patients with lung lesions referred to Ballarat Hospital between 2014 to 2015. Information was collected regarding these cohorts’ demographics, cancer care pathway and diagnosis. Results: 302 patients were analysed in this study, of whom, 266 were managed by the RALLC between 2017 to 2021, and 36 patients were managed pre-RALLC between 2014 and 2015. In this cohort, 161 (53%) were males, 256 (85%) were ECOG 0-1 and 251 (83%) had non-small cell lung cancer (NSCLC). 184 (61%) referrals were from general practitioners and 161 (53%) patients received curative-intent treatment. The median time between referral to appointment was 8 days for the RALLC cohort vs. 11 days for the pre-RALLC cohort. The median time between referral to diagnosis was 20 days for the RALLC cohort vs. 36 days for the pre-RALLC cohort. The median time between referral to treatment was 45 days for the RALLC cohort vs. 62 days for the pre-RALLC cohort. The median time between specialist appointment to diagnosis was 11 days for the RALLC cohort vs. 24 days for the pre-RALLC cohort. Conclusions: Although the RALLC did not significantly reduce time between referral to specialist appointment, the clinic did reduce time between referral and specialist appointment to diagnosis, and the time between referral to treatment. The clinic has achieved a marked improvement in meeting the standards of the Optimal Care Pathway for this regional tertiary centre in Australia and demonstrates the benefits of coordinated multidisciplinary service provision especially where specialist access may be limited. Future research is being undertaken to investigate its impact on the clinical outcomes for patients. [Table: see text]