# Neglected Occupational Risk Factors—A Contributor to Diagnostic Delays in Lung Cancer

## TL;DR

Occupational risk factors for lung cancer are often overlooked, leading to longer delays in diagnosis, which highlights the need for better risk assessment in high-risk workers.

## Contribution

The study shows that occupational exposure is a significant and independent contributor to diagnostic delays in lung cancer.

## Key findings

- Patients with occupational risk had significantly longer time to diagnosis compared to controls.
- Occupational exposure was the only variable statistically associated with increased diagnostic delay in multivariate analysis.
- Follow-up of exposed workers could lead to earlier detection of lung cancer.

## Abstract

What are the main findings?
Due to the long period between the first exposure and the first signs of lung cancer, occupational risk is under evaluated.Patients with occupational risk of lung cancers have longer time to diagnosis.

Due to the long period between the first exposure and the first signs of lung cancer, occupational risk is under evaluated.

Patients with occupational risk of lung cancers have longer time to diagnosis.

What are the implications of the main findings?
Occupational hazards should be included in the risk assessment in order to reduce the time to diagnosis of patients with lung cancer.Follow-up of the workers exposed to lung carcinogens in their workplace could lead to an earlier detection of lung cancer.

Occupational hazards should be included in the risk assessment in order to reduce the time to diagnosis of patients with lung cancer.

Follow-up of the workers exposed to lung carcinogens in their workplace could lead to an earlier detection of lung cancer.

Introduction: For lung cancer, the total interval time to diagnosis (TITD) is very important. If not detected by the screening program, the actual guidelines emphasize the need for a short delay to assure the initiation of treatment before 2 months from the initial symptoms. In order to shorten TITD, the individual risk has to be properly assessed by the primary physician. Objective: The assessment of the influence of the occupational exposure on the diagnostic delay—from the onset of symptoms to confirmed diagnosis—in a population of patients with lung cancer. Material and methods: A total of 110 cases were recruited and were divided into two groups based on the individual assessment by an occupational physician. Results: There were 38 cases (34.55%) at high risk according to their occupational exposure and 72 controls. On average, the TITD was 3.41 +/−5.12 months. The TITD was significantly longer in the high-risk group (p = 0.03). A larger proportion cases had longer TITD: 55.17% of cases vs. 44.83% of controls (p = 0.006). In a multivariate analysis including covariates’ age, sex, level of education, health literacy, number of packs-years, family history of cancer, and previous lung diseases associated with a high risk of lung cancer, the highest risk derived from the previous occupational exposure was the only variable statistically associated with TITD (OR = 10.57, 2.06–54.34, p = 0.01). Discussion: Awareness about the occupational risk in workers who are or have been exposed and in health providers could reduce the total interval time to diagnosis.