Characteristics, Diagnostic Pathways and Timelines of a Rapid Access Lung Cancer Clinic: A 7-Year Retrospective Cohort Study of 753 Patients.

@article{chiner2026characteristics,
  title = {{Characteristics, Diagnostic Pathways and Timelines of a Rapid Access Lung Cancer Clinic: A 7-Year Retrospective Cohort Study of 753 Patients.}},
  author = {Eusebi Chiner and Anays Martínez-Gómez and Mónica Llombart and Ignacio Boira and Gema Martínez-Carrillo and Esther Pastor},
  journal = {Open respiratory archives},
  year = {2026},
  month = oct,
  doi = {10.1016/j.opresp.2026.100686},
  url = {https://europepmc.org/article/MED/42959375},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Characteristics, Diagnostic Pathways and Timelines of a Rapid Access Lung Cancer Clinic: A 7-Year Retrospective Cohort Study of 753 Patients.
AU  - Eusebi Chiner
AU  - Anays Martínez-Gómez
AU  - Mónica Llombart
AU  - Ignacio Boira
AU  - Gema Martínez-Carrillo
AU  - Esther Pastor
PY  - 2026
DA  - 2026/10/05
JO  - Open respiratory archives
DO  - 10.1016/j.opresp.2026.100686
UR  - https://europepmc.org/article/MED/42959375
AB  - Objective  To describe the characteristics, referral pathways and diagnostic timelines of a high-resolution pulmonology consultation (HRPC) for patients with suspected lung cancer, with particular attention to waiting times, referral origins, diagnostic procedures, independent factors associated with cancer and interval to start of treatment.Design  Observational, descriptive, retrospective cohort study.Participants  753 patients over 16 years of age attended at the HRPC between January 2018 and September 2024 referred for suspected lung cancer or unresolved thoracic lesions.Main measurements  Demographic data, referral origin, time to first visit, number of consultations, diagnostic procedures performed, final clinical diagnosis, time to histological diagnosis, time to discussion at the multidisciplinary tumour committee (MDT) and time to start of treatment. A multivariable binary logistic regression model was fitted on the complete cohort (n = 753) to identify independent factors associated with a final lung-cancer diagnosis (with explicit non-causal interpretation).Results  Mean age 66 ± 13 years; 59% male. Main referral reasons: pulmonary nodules (46%), pulmonary masses (18%) and haemoptysis (18%). Referral sources: Radiology (35%; n = 264), Primary Care (26%; n = 196), Emergency (9%; n = 68) and other services (30%; n = 225). Time to first consultation: median 3.0 days (IQR 2.0-4.0; mean 3.0 ± 2.0), with an upward trend (2.4 d in 2019 to 4.8 d in 2024). Final diagnosis: lung cancer in 29.7% of referrals (n = 224), pulmonary nodules under follow-up in 33% (n = 248), benign haemoptysis in 12% (n = 90). In the cancer cohort (n = 224), median time from first visit to histological diagnosis was 7.7 days (IQR 6.1-9.4), median time from histology to MDT discussion was 5.1 days (IQR 3.8-6.0), and median time from MDT decision to start of treatment was 12.2 days (IQR 9.4-14.7; all 224 cases started treatment within ≤15 days). Median total referral-to-treatment interval was 27.3 days (IQR 24.5-30.5). Multivariable logistic regression identified older age (OR 1.021/yr; 95% CI 1.005-1.038; p = 0.012), shorter waiting time (OR 0.838/d; 95% CI 0.765-0.918; p = 0.0001; reflecting prioritisation of high-suspicion cases), referral for pulmonary mass (OR 25.51; 95% CI 5.08-128.15; p = 0.0001) and referral from Radiology (OR 2.39; 95% CI 1.43-4.01; p = 0.001) as independently associated with cancer, whereas referral for pulmonary nodule showed a non-significant trend (OR 4.14; 95% CI 0.83-20.72; p = 0.084). Histology: adenocarcinoma 51%, squamous cell carcinoma 20%. 63% presented at advanced stages (III-IV).Conclusions  In this 7-year retrospective cohort the rapid access lung cancer clinic achieved short waiting times to first consultation and to start of treatment, detected lung cancer in approximately 30% of referrals, and integrated Primary Care as the second main referral source. The descriptive design does not allow causal claims about pathway effectiveness, but the data provide reference benchmarks (diagnostic timelines, cancer detection rate, associated factors) that may be useful for other centres implementing similar organisational models and support the need for controlled studies to evaluate their impact on outcomes.
SN  - 2659-6636
ER  -