Authors (including presenting author) :
Shong LYW (1)(2), Chong WC (1), Cheang PI (1), Choy WC (2), Lam DCL (1)(2)
Affiliation :
(1) Department of Medicine, Queen Mary Hospital, (2) Department of Medicine, The University of Hong Kong
Introduction :
Lung cancer is the leading cause of cancer-related deaths in Hong Kong in 2021, with a high incidence rate and low five-year survival rate. With the advancement of computerized tomography (CT) technology and its wider clinical use, there has been an increasing trend in detecting lung nodules on CT Thorax scans. The Hong Kong West Cluster implemented a diagnostic and management pathway for patients referred with lung nodule or suspicious lung malignancy in 2022. This program empowered our clinical team to better cohort and monitor patients with lung nodules.
Objectives :
1. To streamline and coordinate the diagnostic journey for patients with lung nodules.
2. To facilitate early and accurate identification and risk stratification of lung nodule.
3. To ensure timely follow-up and further investigation for patients with lung nodules or suspicious lung malignancy.
Methodology :
The project included patients referred to the respiratory clinic for lung nodules or suspicious lung malignancy. Outcome measures were categorized as follows:
1. Number of patients underwent early diagnostic investigations.
2. Number of patients diagnosed with lung cancer.
3. Number of patients diagnosed with early-stage lung cancer.
Result & Outcome :
Results: From January to December 2022, a total of 1471 patients were recruited. Of these, 291 patients (19.8%) underwent early diagnostic procedures, and 133 patients (9.0%) were diagnosed with lung cancer. The distribution of diagnosed lung cancer stages was as follows: 45.9% at Stage I, 7.5% at Stage II, 12.8% at Stage III, and 33.8% at Stage IV. The implementation of the program led to a 2.38-fold increase in the diagnosis of early-stage lung cancer when compared to the data from the Hong Kong Cancer Registry in the previous year, 2021.
Conclusions: The implementation of a diagnostic and management pathway for lung nodule or suspicious lung malignancy has led to an increased detection of early-stage lung cancer diagnoses - a stage shift phenomenon for early detection of lung cancer reported in overseas experience. This improvement has the potential to enhance the survival rates of lung cancer patients and reduce healthcare costs.
