Wait Times in Diagnostic Evaluation and Treatment for Patients With Stage III Non-Small Cell Lung Cancer in British Columbia

Wai, Elaine S.; Mackinnon, Murray; Hooker, R.; Moccia, Patrizia; Perry, Kristi R.; Truong, Pauline T.

doi:10.1097/coc.0b013e3182143cce

Cited by 14 publications

(14 citation statements)

References 29 publications

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“…Regardless of those factors linked to improved TTI and unlike other cancer types, there is no evidence in the current literature that links increase in TTI to decreased survival in the setting of STS. However, the impact of psychosocial distress of STS on longer TTI is not well understood and is believed to be multifactorial as well …”

Section: Discussionmentioning

confidence: 99%

Adult soft tissue sarcoma and time to treatment initiation: An analysis of the National Cancer Database

Curtis

Lawrenz

George

et al. 2018

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Adult soft tissue sarcoma and time to treatment initiation: An analysis of the National Cancer Database

Curtis

Lawrenz

George

et al. 2018

Journal of Surgical Oncology

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“…This ‘grey zone’ is caused by a distributed network of hospitals and clinics responsible for the diagnostic process and their own waiting times and delays. This could contribute to a spuriously shorter median survival and poorer OS, which may be of particular concern in cases of rapidly growing, aggressive tumours such as glioblastoma [ 12 ] or lung cancer [ 13 ]. Such delays are notoriously common, depend on cancer stage [ 14 ], and may have clinical consequences in the form of reduced odds of survival or a missed window of opportunity for radical treatment, as suggested in the study by Wai et al [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…This could contribute to a spuriously shorter median survival and poorer OS, which may be of particular concern in cases of rapidly growing, aggressive tumours such as glioblastoma [ 12 ] or lung cancer [ 13 ]. Such delays are notoriously common, depend on cancer stage [ 14 ], and may have clinical consequences in the form of reduced odds of survival or a missed window of opportunity for radical treatment, as suggested in the study by Wai et al [ 13 ]. However, in contrast to a British study showing a constantly increasing waiting time for breast cancer RTx [ 15 ], in our centre, the number of patients in RTx increased proportionally with the number of newly diagnosed cancer cases, suggesting that the availability of RTx did not decline.…”

Section: Discussionmentioning

confidence: 99%

Availability and outcomes of radiotherapy in Central Poland during the 2005-2012 period - an observational study

et al. 2015

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BackgroundUsing a cross-database integrative approach, we performed an epidemiological analysis in a representative region of central Poland to evaluate the availability of radiotherapy (RTx) and overall survival of adult patients undergoing RTx for cancer.MethodsEpidemiological data on cancer incidence in the 2005–2012 period were obtained from the Nationwide Cancer Registry. Using data from the Ministry of Internal Affairs, we collected survival information of all patients treated in the only centre providing RTx for a region inhabited by approximately 2.6 million people.ResultsAfter filtering out individuals on the basis of exclusion criteria, the final dataset covered 17,736 patients. Availability of RTx increased marginally, from 23.5% (2005) to 24.4% (2011, R = 0.39, p = 0.38), with the highest values noted in patients with cervical (78.5%), prostate (70.6%) and breast cancer (62.7%). However, due to the decreasing population of the region, we noted increasing disparity in the likelihood of receiving RTx depending on the patient’s area of residence, with rural areas becoming progressively more neglected. The best prognosis was noted among patients with breast or prostate cancer with 5-year OS rates reaching 81.2% and 83.3%, respectively. Multivariate analysis controlling for type of diagnosis and patient age showed a time-dependent improvement in outcomes (HR(95% CI): 0.96(0.94-0.98); p < 0.0001).ConclusionsAvailability of RTx in Poland is still below that reported by developed European centres. Survival of patients undergoing radical RTx has gradually improved, although it is still below that of leading RTx departments, potentially due to delayed diagnosis or organisational barriers, necessitating further investigations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1236-7) contains supplementary material, which is available to authorized users.

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“…Determination of timelines of care for lung cancer patients globally has revealed considerable variability [ 10 - 24 ]. For instance, in the United States, time intervals from initial abnormal radiograph to treatment initiation vary from 35 to 84 d [ 14 , 16 - 17 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…For instance, in the United States, time intervals from initial abnormal radiograph to treatment initiation vary from 35 to 84 d [ 14 , 16 - 17 , 20 ]. While relatively few studies have been performed regarding lung cancer wait times within Canada [ 21 - 24 ], one prospective study in Ontario reported a median time interval from development of first symptoms to initiation of treatment of 138 d [ 23 ], while another study from Manitoba reported a median of 145 d from first physician visit to diagnosis [ 22 ]. Such differences in time intervals among various centres highlight the need for individual centres to perform internal quality assurance studies to identify avoidable delays in treatment.…”

Section: Introductionmentioning

confidence: 99%

Wait Times Experienced by Lung Cancer Patients in the BC Southern Interior to Obtain Oncologic Care: Exploration of the Intervals from First Abnormal Imaging to Oncologic Treatment

Chowdhury

Boyce

et al. 2015

Cureus

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Background: Lung cancer is associated with rapid disease progression, which can significantly progress over a duration of four to eight weeks. This study examines the time interval lung cancer patients from the interior of British Columbia (BC) experience while undergoing diagnostic evaluation, biopsy, staging, and preparation for treatment.Methods: A chart review of lung cancer patients (n=231) referred to the BC Cancer Agency Centre for the Southern Interior between January 1, 2010 and December 31, 2011 was performed. Time zero was defined as the date of the first abnormal chest imaging. Time intervals, expressed as median averages, to specialist consult, biopsy, oncologic referral, initial oncology consultation, and commencement of oncologic treatment were obtained.Results: The median time interval from first abnormal chest imaging to a specialist consultation was 18 days (interquartile range, IQR, 7-36). An additional nine days elapsed prior to biopsy in the form of bronchoscopy, CT-guided biopsy, or sputum cytology (median; IQR, 3-21); if lobectomy was required, 18 days elapsed (median; IQR, 9-28). Eight days were required for pathologic diagnosis and subsequent referral to the cancer centre (median; IQR, 3-16.5). Once referral was received, 10 days elapsed prior to consultation with either a medical or radiation oncologist (median, IQR 5-18). Finally, eight days was required for initiation of radiation and/or chemotherapy (median; IQR, 1-15). The median wait time from detection of lung cancer on imaging to oncologic treatment in the form of radiation and/or chemotherapy was 65.5 days (IQR, 41.5-104.3). Interpretation: Patients in the BC Southern Interior experience considerable delays in accessing lung cancer care. During this time, the disease has the potential to significantly progress and it is possible that a subset of patients may lose their opportunity for curative intent treatment.

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Wait Times in Diagnostic Evaluation and Treatment for Patients With Stage III Non-Small Cell Lung Cancer in British Columbia

Abstract: The wait time from first symptom to referral to a regional cancer center in British Columbia for stage III NSCLC was approximately 3 to 4 months. Efforts to reduce wait times are warranted to reduce patient distress and possibly disease progression.

Cited by 14 publications

References 29 publications

Adult soft tissue sarcoma and time to treatment initiation: An analysis of the National Cancer Database

Adult soft tissue sarcoma and time to treatment initiation: An analysis of the National Cancer Database

Availability and outcomes of radiotherapy in Central Poland during the 2005-2012 period - an observational study

Wait Times Experienced by Lung Cancer Patients in the BC Southern Interior to Obtain Oncologic Care: Exploration of the Intervals from First Abnormal Imaging to Oncologic Treatment

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