SOCIODEMOGRAPHIC AND CLINICAL FACTORS ASSOCIATED WITH TIME TO TREATMENT INITIATION AND CARE PATHWAYS IN NON-METASTATIC NON-SMALL CELL LUNG CANCER (NSCLC) IN COLOMBIA: A REAL-WORLD EVIDENCE STUDY
Author(s)
Iader Alfonso Rodríguez-Márquez, MD PHD (c)1, Melissa Diaz Puentes, MSc, MD2, Claudio Flores, MD3, Javier Ospina, MD4, Jose Tatis-Méndez, MD1, Edwin De La Peña-Arrieta, MD5, Carlos Ramírez, MD5, Grey Córdoba-Avendaño, MD6, Sergio Cáceres-Maldonado, MD MSc2, Jose Sanabria, MD ESP MSc7, Laura Prieto, MD MSc2, Juan Flórez-Arango, MD MSc5;
1Fundación Ideas Auna, Medellín, Colombia, 2Evidence Generation Team Roche Colombia, Bogotá, Colombia, 3Fundación Ideas Auna, Lima, Peru, 4Clínica IMAT Oncomédica Auna, Montería, Colombia, 5Instituto de Cancerología Las Américas Auna, Medellín, Colombia, 6Clínica Portoazul Auna, Barranquilla, Colombia, 7Medical Affairs Roche Colombia, Bogotá, Colombia
1Fundación Ideas Auna, Medellín, Colombia, 2Evidence Generation Team Roche Colombia, Bogotá, Colombia, 3Fundación Ideas Auna, Lima, Peru, 4Clínica IMAT Oncomédica Auna, Montería, Colombia, 5Instituto de Cancerología Las Américas Auna, Medellín, Colombia, 6Clínica Portoazul Auna, Barranquilla, Colombia, 7Medical Affairs Roche Colombia, Bogotá, Colombia
OBJECTIVES: Lung cancer has the highest incidence and mortality worldwide. In Colombia, time-to-treatment initiation (TTI) exceeds the 30-day national goal. This study aimed to identify sociodemographic and clinical factors related to TTI in patients with NSCLC between 2017-2024 to optimize care pathways.
METHODS: A retrospective, multicenter, observational study was conducted using real-world data from adult patients with NSCLC in stages IA-IIIC from three high-complexity oncology centers in Colombia. TTI was defined as the time between diagnosis and first treatment. Factors associated with TTI were analyzed using time-to-event analysis with a Kaplan-Meier estimator and a Cox model.
RESULTS: 228 patients were analyzed, 48.2% were diagnosed at stage III, and 28.1% were identified through a screening program. Treatment patterns varied by stage, with surgery being the most common approach in stage I, surgery plus adjuvant therapy in stage II, and systemic therapy in stage III. The median TTI was 78 days (IQR: 47-126) and varied by stages (I:104, II:90, III:63). Univariate analysis showed male sex, urban residence, lower body mass index (BMI) and stage III at diagnosis as possible factors associated with shorter TTI, while multivariate analysis confirmed that the factors related with shorter TTI were male sex (HR:1.58, 95%CI: 1.11-2.27), stage III at diagnosis (HR:1.79, 95%CI: 1.20-2.67), Charlson Comorbidity index ≤2 (HR:1.55, 95%CI: 1.09-2.20) and diagnosis through screening (HR:1.55, 95%CI: 1.03-2.35).
CONCLUSIONS: This study highlights a high proportion of stage III diagnoses and treatment initiation delays exceeding national goals by more than two-fold. Sex, comorbidities, screening, and stage at diagnosis were factors associated with TTI. These findings reinforce the importance of early detection and policies aiming to scale up screening programs and underscore the need for optimized care pathways to minimize treatment delays and reduce health system inequities, enabling timely access to disease-modifying therapies.
METHODS: A retrospective, multicenter, observational study was conducted using real-world data from adult patients with NSCLC in stages IA-IIIC from three high-complexity oncology centers in Colombia. TTI was defined as the time between diagnosis and first treatment. Factors associated with TTI were analyzed using time-to-event analysis with a Kaplan-Meier estimator and a Cox model.
RESULTS: 228 patients were analyzed, 48.2% were diagnosed at stage III, and 28.1% were identified through a screening program. Treatment patterns varied by stage, with surgery being the most common approach in stage I, surgery plus adjuvant therapy in stage II, and systemic therapy in stage III. The median TTI was 78 days (IQR: 47-126) and varied by stages (I:104, II:90, III:63). Univariate analysis showed male sex, urban residence, lower body mass index (BMI) and stage III at diagnosis as possible factors associated with shorter TTI, while multivariate analysis confirmed that the factors related with shorter TTI were male sex (HR:1.58, 95%CI: 1.11-2.27), stage III at diagnosis (HR:1.79, 95%CI: 1.20-2.67), Charlson Comorbidity index ≤2 (HR:1.55, 95%CI: 1.09-2.20) and diagnosis through screening (HR:1.55, 95%CI: 1.03-2.35).
CONCLUSIONS: This study highlights a high proportion of stage III diagnoses and treatment initiation delays exceeding national goals by more than two-fold. Sex, comorbidities, screening, and stage at diagnosis were factors associated with TTI. These findings reinforce the importance of early detection and policies aiming to scale up screening programs and underscore the need for optimized care pathways to minimize treatment delays and reduce health system inequities, enabling timely access to disease-modifying therapies.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD61
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology