Could it Be Diagnosed Earlier? A Retrospective Analysis of Lung Cancer

TL;DR

This study finds that many lung cancer cases could have been diagnosed earlier if radiological images and reports were more carefully reviewed.

Contribution

The study identifies specific radiological features and factors that contribute to diagnostic delays in lung cancer.

Findings

30 out of 76 patients had unrecognized radiological abnormalities in prior imaging.

Diagnostic delays were more common in adenocarcinoma cases and lesions in specific lung regions.

Increased awareness of imaging features could improve early detection of lung cancer.

Abstract

Early diagnosis is one of the most critical factors influencing the prognosis of lung cancer. This study aims to investigate radiological diagnostic delays and their underlying causes in lung cancer.

The previous radiological images of newly diagnosed lung cancer patients were retrospectively reviewed by a multidisciplinary team consisting of 2 chest physicians and 1 radiologist. Radiological abnormalities were identified, and potential factors contributing to delayed diagnosis were analyzed.

Among 100 patients, 76 had prior thoracic imaging. In 22 of these, lesions had been previously identified and patients informed about the potential risk of malignancy, but further evaluation was declined. Retrospective review revealed unrecognized radiological abnormalities in 30 patients—12 on chest X-rays and 18 on computed tomography (CT) scans. In 7 cases, the lesions had been documented in the CT reports. Lesions located in peri-hilar, tracheobronchial, and paravertebral regions, as well as those originating from areas of lung sequelae, were among the most common factors associated with later diagnosis. Diagnostic delays were more common in cases of adenocarcinoma.

A considerable proportion of lung cancer cases might have been detected earlier. Increased awareness of specific radiological features and careful co-evaluation of both imaging reports and the images themselves may enhance earlier detection in lung cancer.

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