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Waiting Time for Breast Cancer Treatment in Alberta

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Abstract

Background: The present study had two research questions. First, what is the average waiting time between diagnosis and treatment for Alberta women with breast cancer relative to Canadian Society for Surgical Oncology (CSSO) recommendations? Second, does patient age, cancer stage, patient community size, and year of diagnosis have a significant relationship to waiting time?

Methods: The sample consisted of all Alberta women diagnosed with breast cancer between 1997 and 2000. Waiting time was defined as number of days between definitive diagnosis and treatment initiation. Multiple regression examined the relative influence of the predictor variables on waiting time.

Results: There were 6,418 cases of breast cancer between 1997 and 2000. Mean waiting time was 20.2 days (SD 21.6) and median waiting time was 17 days. Longer waiting time was significantly associated with year of diagnosis (progressively longer from 1997 to 2000), patients younger than 70, and Stage 1 cancer. Waiting time increase from 1997 to 2000 appears to be due to increased demand for services without corresponding increases in resources. Less treatment delay for women older than 70 is due to more of these women being treated the same day they received their diagnosis.

Conclusion: Only 44% of women had a waiting time of 14 days or less as recommended by the CSSO. The number of women who will have to wait longer than recommended for treatment will likely increase without a significant increase in oncological resources. The basis for differences in waiting times as a function of age needs to be further investigated to ensure equitable access to care.

Résumé

Contexte: L’étude s’articule autour de deux questions de recherche, la première étant le délai d’attente moyen entre le diagnostic et le traitement chez les Albertaines ayant le cancer du sein par rapport aux recommandations de la Société canadienne pour l’oncologie chirurgicale, et la seconde, l’influence éventuelle de l’âge, de la progression du cancer, de la taille de la communauté de la patiente et de l’année du diagnostic sur le délai d’attente.

Méthode: L’échantillon se composait de toutes les Albertaines ayant reçu un diagnostic de cancer du sein entre 1997 et 2000. Le délai d’attente a été défini comme le nombre de jours entre l’évaluation définitive et le début du traitement. Par analyse de régression multiple, nous avons examiné l’influence relative des prédicteurs du délai d’attente.

Résultats: Il y a eu 6 418 cas de cancer du sein entre 1997 et 2000. Le délai d’attente moyen entre le diagnostic et le traitement était de 20,2 jours (écart-type de 21,6), et le délai d’attente médian, de 17 jours. Une attente prolongée était associée de façon significative à l’année du diagnostic (le délai s’est allongé progressivement entre 1997 et 2000), aux patientes de moins de 70 ans, et au premier stade du cancer. L’augmentation du délai d’attente entre 1997 et 2000 semble s’expliquer par la demande accrue de services sans augmentation correspondante des ressources. Le traitement plus rapide des femmes de plus de 70 ans s’explique par le fait que davantage de ces femmes ont été traitées le jour même de leur diagnostic.

Conclusion: Seulement 44 % des femmes ont attendu 14 jours ou moins comme le recommande la Société canadienne pour l’oncologie chirurgicale. Ces délais d’attente élevés continueront sans doute à augmenter sans hausse significative des ressources en oncologie. Pour assurer un accès équitable aux soins, il faudrait étudier plus avant la raison des écarts dus à l’âge dans les délais d’attente.

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Authors and Affiliations

  1. Faculty of Medicine, University of Calgary, Calgary, AB, Canada

    Alyssa D. Reed MSc, Robert J. Williams PhD & Patricia A. Wall MSc

  2. Kelowna, BC, Canada

    Paul Hasselback MD (Senior Medical Health Officer of Interior Health)

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  1. Alyssa D. Reed MSc
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  2. Robert J. Williams PhD
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  3. Patricia A. Wall MSc
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  4. Paul Hasselback MD
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Correspondence to Alyssa D. Reed MSc.

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Reed, A.D., Williams, R.J., Wall, P.A. et al. Waiting Time for Breast Cancer Treatment in Alberta. Can J Public Health 95, 341–345 (2004). https://doi.org/10.1007/BF03405142

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