Lung cancer is among the most common malignant diseases and currently the leading cause of cancer-related deaths in the US and worldwide . The 1- and 5-year overall survival rates for lung cancer patients (47% and 18%, respectively) are far below the average cancer survival rate . Due to the majority of patients being diagnosed with advanced stage of lung cancer, oncologists deem it to be one of the most relevant types of cancer to study the relationship between time-to-treatment initiation (TTI) and clinical outcome.
TTI needs to be addressed to improve lung cancer outcomes because treatment delays following diagnosis will impact patient survival . In general, timely care positively affects survival of patients which are driven in part by the risk of disease progression during avoidable delays. Current clinical practice guidelines recommend time to starting lung cancer treatment ranges from 31 days to 3 months in different countries [4-7]. US guidelines to initiate treatment within 41 days of diagnosis of NSCLC. The British National Health Service (NHS) recommends treatment to initiate within 31 days of clinical decision to treat. In Norway, the recommended timeframes from receiving a referral letter to the start of treatment are 35 calendar days for systemic cancer therapy and 42 days for surgery and radiotherapy. In the Netherlands, treatment is recommended to start within 35 calendar days of the patient’s first visit to a pulmonologist.