Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada
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 evaluate...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/30/5/368 |
| _version_ | 1797600452690313216 |
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| author | Shahad AlGhamdi Weidong Kong Michael Brundage Elizabeth A. Eisenhauer Christopher M. Parker Geneviève C. Digby |
| author_facet | Shahad AlGhamdi Weidong Kong Michael Brundage Elizabeth A. Eisenhauer Christopher M. Parker Geneviève C. Digby |
| author_sort | Shahad AlGhamdi |
| collection | DOAJ |
| description | 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, <i>p</i> < 0.0001). Increasing distance from the LDAP was associated with a lower likelihood of LDAP management (OR 0.78 for every 20 km increase, <i>p</i> < 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. |
| first_indexed | 2024-03-11T03:49:18Z |
| format | Article |
| id | doaj.art-084353b61044492696d66aefff77c821 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-11T03:49:18Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-084353b61044492696d66aefff77c8212023-11-18T01:01:48ZengMDPI AGCurrent Oncology1198-00521718-77292023-05-013054880489610.3390/curroncol30050368Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, CanadaShahad AlGhamdi0Weidong Kong1Michael Brundage2Elizabeth A. Eisenhauer3Christopher M. Parker4Geneviève C. Digby5Department of Medicine, Division of Respirology, 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 Medicine, Division of Respirology, Queen’s University, Kingston, ON K7L 2V7, CanadaIntroduction: 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, <i>p</i> < 0.0001). Increasing distance from the LDAP was associated with a lower likelihood of LDAP management (OR 0.78 for every 20 km increase, <i>p</i> < 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.https://www.mdpi.com/1718-7729/30/5/368lung cancermultidisciplinary clinicsystem barriersmortalityOntario |
| spellingShingle | Shahad AlGhamdi Weidong Kong Michael Brundage Elizabeth A. Eisenhauer Christopher M. Parker Geneviève C. Digby Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada Current Oncology lung cancer multidisciplinary clinic system barriers mortality Ontario |
| title | Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada |
| title_full | Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada |
| title_fullStr | Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada |
| title_full_unstemmed | Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada |
| title_short | Characterizing Variability in Lung Cancer Outcomes and Influence of a Lung Diagnostic Assessment Program in Southeastern Ontario, Canada |
| title_sort | characterizing variability in lung cancer outcomes and influence of a lung diagnostic assessment program in southeastern ontario canada |
| topic | lung cancer multidisciplinary clinic system barriers mortality Ontario |
| url | https://www.mdpi.com/1718-7729/30/5/368 |
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