Retrospective cohort study of frequent missed opportunities for earlier diagnosis of advanced-stage colorectal or lung cancer

Missed and delayed cancer diagnoses worsen patients outcomes. Overlooking cancer-related diagnostic signals may result in advanced-stage presentations. A retrospective cohort study investigated the association between a digital quality meaure for advanced-stage cancer and prior missed opportunities for cancer diagnosis. In this cohort study of 37,691 patients from the Department of Veterans Affairs (VA) health system and 2914 patients from Geisinger Health System with lung cancer and 14,674 patients from the VA health system and 627 patients from Geisinger with colorectal cancer, the proportion of advanced-stage lung cancer was 45.9% at the VA health system and 58.3% at Geisinger, with frequent missed opportunities for earlier diagnosis (58.9% and 77.8%, respectively). The proportion of advanced-stage colorectal cancer was 33.2% at the VA health system and 36.2% at Geisinger, and most patients had missed opportunities (66.3% and 69.7%, respectively). Median diagnostic delays in the cohort ranged from 1 to 20 months. The authors conclude that an advanced-stage cancer digital quality measure can help health systems measure preventable delays in cancer diagnosis.