Background: Lung cancer is the leading cause of cancer-related death in Denmark. The prognosis has been associated with route to diagnosis (RtD). Based on earlier register-based studies, having an emergency presentation (EMP) is associated with a worse outcome. Here with medical records as data source, we explore how RtD affects survival of Danish lung cancer patients.

Method: We included patients that according to the Danish Lung Cancer Registry were diagnosed with non-small cell lung cancer from 2014 to 2016. Data on study variables were collected from medical records. We established overall one-year survival according to EMP or non-EMP RtD and also stratified according to curative (<stage IIIa) or non-curative stage (>IIIa).

Results: We included 853 patients. The main Rtd was through GP and 193 (22,7%) through EMP, the third most common RtD. In the EMP-group, 73% had non-curative disease vs. 52% in the non-EMP group (p<0.001). In the EMP group 39% were alive one year after diagnosis vs. 59% in the non-EMP group (p<0.001). When stratified according to curative vs non-curative stage, having EMP RtD was only associated with excess one-year mortality in the non-curative group, where 29% in the EMP group were alive after one year vs. 40% in the non-EMP group (p=0.022).

Conclusion: We have collected accurate data on RtD among Danish Lung Cancer patients, these data are important for benchmarking the register-based studies in this area. EMP RtD is associated with having incurable stage and excess mortality.

Routes to diagnosis N %
General Practice 400 47
EMD 193 23
Other department 205 24
Nodulus surveillance 41 5
Unknown 14 2
Total 853 100