This study assessed data from an audit of secondary care management in Auckland-Northland of 565 lung cancer patients diagnosed in 2004, to determine entry routes into and transit times in secondary care. Most patients (198; 35%) entered secondary care via the emergency department (ED), especially those with metastatic disease. The median time from entry to diagnosis was 22 days overall, but only 11 days when entry occurred via ED. The median time from entry to treatment was 64 days; 59 days for palliative treatment and 76 days for curative treatment. Initiation of treatment within internationally recommended timeframes occurred for 41% patients undergoing surgical resection, 36% receiving definitive (56% palliative) radiation therapy and 40% receiving chemotherapy. In multivariate analysis, factors that influenced these times included the entry route, the presenting symptoms, the investigations performed, the tumour type, multidisciplinary discussion and Mäori ethnicity.
