Wait times for cancer surgery in the United States: Trends and predictors of delays

Karl Y Bilimoria, Clifford Y. Ko, James S. Tomlinson, Andrew K. Stewart, Mark S. Talamonti, Denise L. Hynes, David P. Winchester, David Jason Bentrem

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

Background: Patients frequently voice concerns regarding wait times for cancer treatment; however, little is known about the length of wait times from diagnosis to surgery in the United States. Our objectives were (1) to assess changes in wait times over the past decade and (2) to identify patient, tumor, and hospital factors associated with prolonged wait times for initial cancer treatment. Methods: Using the National Cancer Data Base (1995-2005), 1,228,071 patients were identified who underwent resection for nonmetastatic breast, colon, esophageal, gastric, liver, lung, pancreatic, and rectal cancer at 1443 hospitals. Multivariable models were developed to assess factors associated with time to treatment. Results: From 1995 to 2005, the median time from diagnosis to treatment increased for all cancers (P < 0.0001). The time from diagnosis to treatment was significantly longer at National Cancer Institute Comprehensive Cancer Centers and Veterans' Administration institutions versus community hospitals (P < 0.0001). On multivariable analysis, patients were significantly more likely to undergo initial treatment > 30 days from diagnosis if older (6 of 8 cancers), black (5 of 8 cancers), had more comorbidities (6 of 8 cancers), had Stage I disease (7 of 8 cancers), or were treated at National Cancer Institute Comprehensive Cancer Centers or Veterans' Affairs institutions (all cancers). Conclusions: Wait times for cancer treatment have increased over the last decade. As case loads increase, wait times for treatment are likely to continue increasing, potentially resulting in additional treatment delay. Additional resources and strategies are needed to reduce wait times for cancer treatment in the United States.

Original languageEnglish (US)
Pages (from-to)779-785
Number of pages7
JournalAnnals of Surgery
Volume253
Issue number4
DOIs
StatePublished - Apr 1 2011

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Neoplasms
Therapeutics
National Cancer Institute (U.S.)
Veterans
Liver Neoplasms
Esophageal Neoplasms
Rectal Neoplasms
Pancreatic Neoplasms
Colonic Neoplasms
Stomach Neoplasms
Comorbidity
Lung Neoplasms
Databases
Breast Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Bilimoria, Karl Y ; Ko, Clifford Y. ; Tomlinson, James S. ; Stewart, Andrew K. ; Talamonti, Mark S. ; Hynes, Denise L. ; Winchester, David P. ; Bentrem, David Jason. / Wait times for cancer surgery in the United States : Trends and predictors of delays. In: Annals of Surgery. 2011 ; Vol. 253, No. 4. pp. 779-785.
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abstract = "Background: Patients frequently voice concerns regarding wait times for cancer treatment; however, little is known about the length of wait times from diagnosis to surgery in the United States. Our objectives were (1) to assess changes in wait times over the past decade and (2) to identify patient, tumor, and hospital factors associated with prolonged wait times for initial cancer treatment. Methods: Using the National Cancer Data Base (1995-2005), 1,228,071 patients were identified who underwent resection for nonmetastatic breast, colon, esophageal, gastric, liver, lung, pancreatic, and rectal cancer at 1443 hospitals. Multivariable models were developed to assess factors associated with time to treatment. Results: From 1995 to 2005, the median time from diagnosis to treatment increased for all cancers (P < 0.0001). The time from diagnosis to treatment was significantly longer at National Cancer Institute Comprehensive Cancer Centers and Veterans' Administration institutions versus community hospitals (P < 0.0001). On multivariable analysis, patients were significantly more likely to undergo initial treatment > 30 days from diagnosis if older (6 of 8 cancers), black (5 of 8 cancers), had more comorbidities (6 of 8 cancers), had Stage I disease (7 of 8 cancers), or were treated at National Cancer Institute Comprehensive Cancer Centers or Veterans' Affairs institutions (all cancers). Conclusions: Wait times for cancer treatment have increased over the last decade. As case loads increase, wait times for treatment are likely to continue increasing, potentially resulting in additional treatment delay. Additional resources and strategies are needed to reduce wait times for cancer treatment in the United States.",
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Bilimoria, KY, Ko, CY, Tomlinson, JS, Stewart, AK, Talamonti, MS, Hynes, DL, Winchester, DP & Bentrem, DJ 2011, 'Wait times for cancer surgery in the United States: Trends and predictors of delays', Annals of Surgery, vol. 253, no. 4, pp. 779-785. https://doi.org/10.1097/SLA.0b013e318211cc0f

Wait times for cancer surgery in the United States : Trends and predictors of delays. / Bilimoria, Karl Y; Ko, Clifford Y.; Tomlinson, James S.; Stewart, Andrew K.; Talamonti, Mark S.; Hynes, Denise L.; Winchester, David P.; Bentrem, David Jason.

In: Annals of Surgery, Vol. 253, No. 4, 01.04.2011, p. 779-785.

Research output: Contribution to journalArticle

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T1 - Wait times for cancer surgery in the United States

T2 - Trends and predictors of delays

AU - Bilimoria, Karl Y

AU - Ko, Clifford Y.

AU - Tomlinson, James S.

AU - Stewart, Andrew K.

AU - Talamonti, Mark S.

AU - Hynes, Denise L.

AU - Winchester, David P.

AU - Bentrem, David Jason

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N2 - Background: Patients frequently voice concerns regarding wait times for cancer treatment; however, little is known about the length of wait times from diagnosis to surgery in the United States. Our objectives were (1) to assess changes in wait times over the past decade and (2) to identify patient, tumor, and hospital factors associated with prolonged wait times for initial cancer treatment. Methods: Using the National Cancer Data Base (1995-2005), 1,228,071 patients were identified who underwent resection for nonmetastatic breast, colon, esophageal, gastric, liver, lung, pancreatic, and rectal cancer at 1443 hospitals. Multivariable models were developed to assess factors associated with time to treatment. Results: From 1995 to 2005, the median time from diagnosis to treatment increased for all cancers (P < 0.0001). The time from diagnosis to treatment was significantly longer at National Cancer Institute Comprehensive Cancer Centers and Veterans' Administration institutions versus community hospitals (P < 0.0001). On multivariable analysis, patients were significantly more likely to undergo initial treatment > 30 days from diagnosis if older (6 of 8 cancers), black (5 of 8 cancers), had more comorbidities (6 of 8 cancers), had Stage I disease (7 of 8 cancers), or were treated at National Cancer Institute Comprehensive Cancer Centers or Veterans' Affairs institutions (all cancers). Conclusions: Wait times for cancer treatment have increased over the last decade. As case loads increase, wait times for treatment are likely to continue increasing, potentially resulting in additional treatment delay. Additional resources and strategies are needed to reduce wait times for cancer treatment in the United States.

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