The role of a suspicion of cancer clinic in lung cancer care.

Abstract

e23105 Background: In 2018, Illinois Cancer Care and UnityPoint Health (now Carle Health) in a collaborative agreement, started the Suspicion of Cancer (SOC) Clinic in Peoria, Illinois. The clinic was created with a goal to expedite the screening and diagnosis of suspected malignancies. The SOC's main focus has been to reduce consultation to diagnosis times and to help navigate patients through the healthcare system with compassion via a physician-led, community-centered clinic. Methods: The SOC Clinic is led by an internal medicine physician and consists of an oncology APN and navigation team members. Referrals are received from community-based hospital systems with Carle Health as the primary source. Referring health care professions include primary care physicians (70%), primary care APN/PA's (19%), and various other physician specialists (11%). Several processes have been revised since inception, including imaging/biopsy referrals, navigation team roles, screening procedures, and efficient use of the EMR. The SOC clinic investigates many types of potential malignancies with lung cancer being the most prevalent (41.8%) from 2022-2024. The primary objective in this study is to evaluate the effectiveness of a physician-led SOC clinic on reducing patient-care time parameters with expedited work-up. Results: From January 2022 through March 2024 the SOC received 80 unique referrals that resulted in a primary lung cancer malignancy diagnosis. The average patient age was 67.84 ± 8.33 years (n = 80). The percentage of anytime smokers in the sample was 95%. For the Referral-Consult and Consult-Diagnosis values, RAND Corporation criteria (over 60-days to diagnosis) and any patient-related delays over 8x the SD were utilized to establish patient delay exclusion criteria. Non-SOC-related patient delays which surpassed RAND criteria or the SD cutoff included personal patient deferrals (n = 2) or delays due to other medical comorbidities (n = 2) to account for 76 patients in the analysis. The average Referral-Consult time in business days (not including weekends or national holidays) was 4.80 ± 2.43 days (n = 76). The average Consult-Diagnosis time was 14.73 ± 9.46 days (n = 76). For Consult-Diagnosis, RAND Corporation criteria were utilized to establish over 42-days to treatment (non-SOC-related) as patient delays. Non-SOC-related patient delays in treatment included personal patient deferrals (n = 5), medical comorbidities delaying treatment (n = 9), or delays due to a non-SOC medical process (n = 16) to account for 50 patients in the analysis. The average Diagnosis-Treatment time was 24.42 ± 10.64 days (n = 50). Conclusions: The Suspicion of Cancer (SOC) Clinic in Peoria, IL offers an interdisciplinary system to expedite cancer work-up and consult to diagnosis in a community setting in central Illinois. This study sought to evaluate the effectiveness of a community-based, physician-driven SOC clinic on optimizing cancer diagnosis and care parameters.