Cancer Patient Pathways shortens waiting times and accelerates the diagnostic process of suspected sarcoma patients in Denmark

Dyrop, Heidi Buvarp; Safwat, Akmal; Vedsted, Peter; Maretty-Nielsen, Katja; Hansen, Bjarne Hauge; Jørgensen, Peter; Baad‐Hansen, Thomas; Bünger, Cody; Keller, Johnny

doi:10.1016/j.healthpol.2013.09.012

Cited by 33 publications

(29 citation statements)

References 22 publications

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“…Encouraged by governments and patient lobbies, fast-track programs are introduced throughout Europe to optimize care pathways and minimize the time for diagnosis, staging and treatment. There is evidence that these programs are reducing total waiting time, though these initiatives are not leading to waiting times that meet current standards set by professional societies and authorities [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival

et al. 2015

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“…Although the CPP for sarcomas reduced the waiting times at ASC (Dyrop et al. 2013), the waiting times that occur locally outside ASC are still very long. The Danish CPP contains no time limits for the diagnostic process at local hospitals, and our results show that when the CPP for sarcoma does not include pre-referral imaging as a part of the fast-track program, a large group of patients have a delayed diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Imaging investigations before referral to a sarcoma center delay the final diagnosis of musculoskeletal sarcoma

et al. 2017

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Background and purposeThe use of point-of-care or local investigations before referral to specialist sarcoma centers as part of a fast-track diagnostic pathway varies, and may affect the time to diagnosis. We wanted to investigate differences in time intervals and proportion of malignancy in patients who were referred after initial diagnostic investigations were performed locally and in patients who were referred without these investigations.Patients and methodsWe included 545 consecutive patients who were referred to Aarhus Sarcoma Center for suspected musculoskeletal sarcoma. Data on time intervals and investigations performed were collected from questionnaires and patient records. Patients who were referred from outside Aarhus uptake area after initial MRI/CT or histology performed locally were compared with patients who were referred from Aarhus uptake area without these investigations.ResultsThe median total interval from first symptom to diagnosis was 166 days for outside patients referred with MRI/CT or histology, which was 91 (95% CI: 76–106) days longer than for local patients who were referred without MRI/CT or histology. Comparing the same groups, the median diagnostic interval was 41 (95% CI: 30–51) days longer for outside patients including both primary care and hospital intervals. Both the proportion of malignancies (38% vs. 14%) and the proportion of sarcomas (24% vs. 7%) were higher in the outside group referred with MRI/CT or histology than in the local group without MRI/CT or histology.InterpretationPre-referral investigations at a local hospital increased the diagnostic interval by at least 1 month for 50% of the patients, and the proportion of malignancy was more than doubled—to almost 40%. If investigations are to be performed before referral to a sarcoma center, they should be part of the fast-track pathway in order to ensure timely diagnosis.

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“…So far, publications based on the DSD included clinical results of inverse shoulder prosthesis after tumor resection,6 alarm symptoms of soft tissue and bone sarcomas,7 some effects of cancer patient pathways,8 a Danish validation of the TESS-score,9 and a characterization of tumor type in patients referred after unplanned excision of tumor outside a sarcoma center 10…”

Section: Examples Of Researchmentioning

confidence: 99%

The Danish Sarcoma Database

Jørgensen¹,

Lausten²,

Pedersen³

2016

CLEP

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AimThe aim of the database is to gather information about sarcomas treated in Denmark in order to continuously monitor and improve the quality of sarcoma treatment in a local, a national, and an international perspective.Study populationPatients in Denmark diagnosed with a sarcoma, both skeletal and ekstraskeletal, are to be registered since 2009.Main variablesThe database contains information about appearance of symptoms; date of receiving referral to a sarcoma center; date of first visit; whether surgery has been performed elsewhere before referral, diagnosis, and treatment; tumor characteristics such as location, size, malignancy grade, and growth pattern; details on treatment (kind of surgery, amount of radiation therapy, type and duration of chemotherapy); complications of treatment; local recurrence and metastases; and comorbidity. In addition, several quality indicators are registered in order to measure the quality of care provided by the hospitals and make comparisons between hospitals and with international standards.Descriptive dataDemographic patient-specific data such as age, sex, region of living, comorbidity, World Health Organization’s International Classification of Diseases – tenth edition codes and TNM Classification of Malignant Tumours, and date of death (after yearly coupling to the Danish Civil Registration System). Data quality and completeness are currently secured.ConclusionThe Danish Sarcoma Database is population based and includes sarcomas occurring in Denmark since 2009. It is a valuable tool for monitoring sarcoma incidence and quality of treatment and its improvement, postoperative complications, and recurrence within 5 years follow-up. The database is also a valuable research tool to study the impact of technical and medical interventions on prognosis of sarcoma patients.

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Cancer Patient Pathways shortens waiting times and accelerates the diagnostic process of suspected sarcoma patients in Denmark

Cited by 33 publications

References 22 publications

Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival

Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival

Imaging investigations before referral to a sarcoma center delay the final diagnosis of musculoskeletal sarcoma

The Danish Sarcoma Database

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