A comparison of the effect of time-to-treatment on survival according to economic status of lung cancer patients with chronic diseases in Korea

Background: The relationship between the provision of timely treatment to lung cancer patients with chronic diseases and their survival rate has not been previously examined. Therefore, this study aimed to investigate the association between time-to-treatment and five-year mortality in lung cancer patients with diabetes, hypertension, and dyslipidemia. Methods: : The data for the study were drawn from the National Health Insurance elderly cohort data (2002-2019). The participants were 2023 lung cancer patients with diabetes, hypertension, or dyslipidemia who underwent surgery. The Cox proportional hazards model was used to analyze the impact of time-to-treatment for first cancer treatment on five-year mortality. The cut-off value for time-to-treatment was set at 30 days. Sub-group analyses were conducted according to the economic status, and the level of comorbidities. Results: : Compared to individuals who received their first treatment for lung cancer in less than 30 days from diagnosis, patients who received their treatment after 30 days showed a higher risk of five-year mortality (HR 1.328, 95% CI 1.077-1.639). This difference in mortality risk was magnified in individuals of lower economic status and among those with a higher level of comorbidities. Conclusion: Lung cancer patients with diabetes, hypertension, or dyslipidemia, who began their treatment for cancer 30 days after diagnosis, had a higher five-year mortality rate. This emphasizes the importance of avoiding delays in the treatment and management of lung cancer among patients with chronic diseases.