Being told that you have lung cancer is one of the most frightening moments in a person’s life. Many patients want treatment to start immediately.
Doctors also feel pressure to act quickly. But modern cancer care has become much more complex than it was in the past. Today, doctors often need special laboratory tests before deciding which treatment is best.
A new study led by researchers at the Medical University of South Carolina (MUSC) found that these important tests are taking much longer than many doctors realize. The study was published in JCO Oncology Practice.
The researchers discovered that the time from a patient’s biopsy to receiving biomarker test results is about twice as long as many doctors estimate.
Biomarker testing looks for certain features inside a tumor. In lung cancer, these tests can identify specific gene changes or other biological signs that help doctors choose the most effective treatment. In recent years, many new medicines have been developed to target particular genetic changes in cancer cells.
These treatments can sometimes work very well and may cause fewer side effects than traditional chemotherapy. Immunotherapy, which helps the body’s immune system attack cancer, has also changed lung cancer treatment.
However, these treatments do not work equally well for everyone. Some patients may benefit greatly from targeted drugs, while others may respond better to immunotherapy. Giving the wrong treatment first can delay recovery and even cause complications.
The MUSC team, led by Dr. Adam Fox and Dr. Gerard Silvestri, studied biomarker testing times for several types of solid cancers between 2018 and 2024. They paid special attention to non-small cell lung cancer, which is the most common type of lung cancer.
The researchers divided the process into several steps. First, doctors must order the test after a biopsy confirms cancer. Then the tissue sample has to be packaged and shipped to a laboratory. Finally, the laboratory performs the testing and sends back the results.
The study found some progress. The overall waiting time improved from 36 days in 2018 to 27 days in 2024. However, nearly all of this improvement came from laboratories becoming faster at performing the tests. The time taken to actually order the tests did not improve. In fact, it became slightly worse.
The differences between hospitals were striking. At the best-performing centers, it took around eight days to order testing. At slower hospitals, it took around twenty-three days just to place the order. In some cases, it took as long as thirty days.
Researchers believe that many doctors underestimate these delays because they only see part of the process. A previous survey found that many lung specialists thought the entire process took only about two weeks. The study showed that the average waiting time was closer to four weeks.
These delays matter because treatment decisions depend heavily on biomarker information. Patients and doctors often feel anxious when facing cancer and may choose to begin treatment before the test results arrive. Unfortunately, this can sometimes lead to problems.
For example, a patient may start immunotherapy and later learn that a targeted drug would have been the better choice. Switching treatments can increase the risk of lung inflammation called pneumonitis.
This condition can cause long-lasting breathing problems. Some treatments can also weaken patients through side effects, making future treatments more difficult. In certain cases, patients may become unable to participate in clinical trials that could have offered new options.
Some hospitals have introduced systems to speed up testing. At MUSC, pathologists automatically order biomarker testing as soon as lung cancer cells are identified. This approach is called reflex testing. However, many hospitals do not have the staff, expertise, or laboratory resources needed to create such systems.
Insurance and payment rules may also contribute to delays. Some doctors remember when biomarker testing was not covered by insurance and patients faced very high bills. Certain Medicare payment rules may also discourage testing during hospital stays because reimbursement can become complicated.
Another challenge is that no clear agreement exists about who should order biomarker testing. Sometimes the responsibility falls to whichever doctor happens to be involved, and this often means the oncologist becomes the last person in the chain to request the tests.
The researchers believe this issue extends beyond lung cancer. Although biomarker testing is not equally important for every cancer type, it is becoming increasingly valuable throughout cancer medicine.
The study highlights an important lesson. Scientific advances can only help patients if healthcare systems are organized efficiently enough to deliver them. New cancer medicines continue to become more personalized, but patients cannot benefit from these treatments if critical test results arrive too late.
The findings suggest that improving communication, creating clear procedures, and reducing unnecessary delays could help many people receive the right treatment at the right time. In cancer care, even a few weeks can make a meaningful difference.
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Source: Medical University of South Carolina.
