Researchers implemented a program to improve timeliness of diagnosis and staging of patients with suspected lung cancer, and they showed positive results with this program in a report published in JCO Oncology Practice.

“Timely [lung cancer] care is critical because delays are associated with disease progression and altered treatment options,” wrote the researchers in their report.

The program for treating patients with suspected lung cancer was a standardized triage process (STP) that included routine nurse-physician triage, preordered staging tests, guidance for inappropriate referrals, and development of a small nodule clinic.

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In this retrospective analysis, timeliness of diagnosis following referral was the main outcome of interest. Patients were divided into 2 groups. One was a baseline group of 207 patients referred during a pre-STP period between January and April of 2018. The other group consisted of 626 patients who underwent the STP during a period from May 2018 to March 2019.

Overall, the mean time from referral to diagnosis was 38.0 days for the baseline group, compared with 22.7 days for patients in the STP group. For the patients who underwent the STP, the mean time between referral and positron emission tomography (PET) scan was 15.7 days, compared with 38.5 days for the baseline group. The mean time from referral to brain imaging was 33.4 days in the baseline group, and it was 13.1 days with the STP.

The use of preordered tests was associated with significantly shorter times to treatment for PET scans, brain imaging using computed tomography/magnetic resonance imaging, and diagnosis (P =.0001 for each). For mean time from referral to diagnosis, this reflected a reduction from 39.9 days to 28.1 days with preordered tests.

The researchers concluded that this STP program was associated with improved efficiency and timeliness in the diagnosis and staging of patients with lung cancer.


Mullin MLL, Tran A, Golemiec B, et al. Improving timeliness of lung cancer diagnosis and staging investigations through implementation of standardized triage pathways. JCO Oncol Pract. Published online July 8, 2020. doi:10.1200/JOP.19.00807