共病可能会延迟肺癌的诊断，因为它会要求全科医生的时间减少及时进行癌症检查的可能性（“竞争需求条件”），或对体征/症状提供合理的非癌症解释（“替代解释条件”）临床实践研究数据链中识别出 1955 年之前出生并在 1990 年至 2019 年间诊断出突发肺癌的患者，并关联入院和癌症登记数据。诊断间隔被定义为从首次出现初级保健并出现相关体征/症状到诊断日期的时间。 14种合并症被分类为十种“竞争需求”和四种“替代解释”条件。使用多变量线性回归模型研究了与诊断间隔的关联。可获得 11870 名肺癌患者的完整数据。在调整后的分析中，患有“替代解释”病症的患者的诊断间隔较长，患有一种和≥2种病症的患者与没有病症的患者分别延长了31天和74天。 “竞争需求”条件的数量没有保留在诊断间隔的最终调整回归模型中。为肺癌症状提供替代解释的条件与增加的诊断间隔相关。临床指南应纳入替代原因和竞争原因对延迟诊断的影响。© 2024。作者。

Comorbid conditions may delay lung cancer diagnosis by placing demand on general practioners' time reducing the possibility of prompt cancer investigation ("competing demand conditions"), or by offering a plausible non-cancer explanation for signs/symptoms ("alternative explanation conditions").Patients in England born before 1955 and diagnosed with incident lung cancer between 1990 and 2019 were identified in the Clinical Practice Research Datalink and linked hospital admission and cancer registry data. Diagnostic interval was defined as time from first presentation in primary care with a relevant sign/symptom to the diagnosis date. 14 comorbidities were classified as ten "competing demand" and four "alternative explanation" conditions. Associations with diagnostic interval were investigated using multivariable linear regression models.Complete data were available for 11870 lung cancer patients. In adjusted analyses diagnostic interval was longer for patients with "alternative explanation" conditions, by 31 and 74 days in patients with one and ≥2 conditions respectively versus those with none. Number of "competing demand" conditions did not remain in the final adjusted regression model for diagnostic interval.Conditions offering alternative explanations for lung cancer symptoms are associated with increased diagnostic intervals. Clinical guidelines should incorporate the impact of alternative and competing causes upon delayed diagnosis.© 2024. The Author(s).