Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada

Shahad AlGhamdi; Weidong Kong; Michael Brundage; Elizabeth A Eisenhauer; Christopher M Parker; Geneviève C Digby

doi:10.3390/curroncol30050368

Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada

Curr Oncol. 2023 May 9;30(5):4880-4896. doi: 10.3390/curroncol30050368.

Authors

Shahad AlGhamdi¹, Weidong Kong², Michael Brundage³, Elizabeth A Eisenhauer³, Christopher M Parker^{1

4}, Geneviève C Digby^{1

3}

Affiliations

¹ Department of Medicine, Division of Respirology, Queen's University, Kingston, ON K7L 2V7, Canada.
² Cancer Care and Epidemiology Research Unit, Queen's University, Kingston, ON K7L 2V7, Canada.
³ Department of Oncology, Queen's University, Kingston, ON K7L 2V7, Canada.
⁴ Department of Critical Care Medicine, Queen's University, Kingston, ON K7L 2V7, Canada.

Abstract

Introduction: Regional variability in lung cancer (LC) outcomes exists across Canada, including in the province of Ontario. The Lung Diagnostic Assessment Program (LDAP) in southeastern (SE) Ontario is a rapid-assessment clinic that expedites the management of patients with suspected LC. We evaluated the association of LDAP management with LC outcomes, including survival, and characterized the variability in LC outcomes across SE Ontario.

Methods: We conducted a population-based retrospective cohort study by identifying patients with newly diagnosed LC through the Ontario Cancer Registry (January 2017-December 2019) and linked to the LDAP database to identify LDAP-managed patients. Descriptive data were collected. Using a Cox model approach, we compared 2-year survival for patients managed through LDAP vs. non-LDAP.

Results: We identified 1832 patients, 1742 of whom met the inclusion criteria (47% LDAP-managed and 53% non-LDAP). LDAP management was associated with a lower probability of dying at 2 years (HR 0.76 vs. non-LDAP, p < 0.0001). Increasing distance from the LDAP was associated with a lower likelihood of LDAP management (OR 0.78 for every 20 km increase, p < 0.0001). LDAP-managed patients were more likely to receive specialist assessment and undergo treatments.

Conclusions: In SE Ontario, initial diagnostic care provided via LDAP was independently associated with improved survival in patients with LC.

Keywords: Ontario; lung cancer; mortality; multidisciplinary clinic; system barriers.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Lung
Lung Neoplasms* / diagnosis
Lung Neoplasms* / therapy
Ontario
Proportional Hazards Models
Retrospective Studies

Grants and funding

This research was funded by an Ontario Lung Association Young Investigator Award with matching funds provided by the Translation Institute of Medicine at Queen’s University, as well as a Division of Respirology UHKF Research Award.