Cancer patients face steadily longer waits to begin treatment, study of 2.7 million patients finds
核心洞察
A study of more than 2.7 million patients found wait times between cancer diagnosis and first treatment have steadily grown over the last few decades.
Wait times rose from weeks to over a month across six common cancers, including breast, colon, lung, pancreatic, gastric and esophageal cancer (搜索).
Black Americans, uninsured or Medicare patients, and those treated in the West or at large academic centers were disproportionately affected by longer delays.
Waiting for treatment to start can be an excruciating period for cancer patients, who may fear the disease is spreading or progressing to a point where therapies become less effective. Yet over the last few decades, the time cancer patients wait between diagnosis and treatment has steadily grown, according to a new study of more than 2.7 million patients.
"What was striking was the consistency," said Tim Donahue, the senior author on the study and a surgical oncologist at the University of California, Los Angeles. "Across every cancer we studied, patients are waiting longer today than they were a decade ago."
Study Design and Scope
Donahue and his colleagues analyzed data from the National Cancer Database (搜索), a national data repository from the American College of Surgeons (搜索), covering the period from 2012 to 2023. The researchers examined only patients with stage 1 to 3 cancers that were considered eligible for surgery at diagnosis across six different cancers. They then compared the time between diagnosis and any first treatment, which included surgery as well as radiation, chemotherapy, or other medical therapies.
The six cancer types studied were breast, colon, lung, pancreatic, gastric, and esophageal cancer (搜索). Wait times increased from weeks to over a month for these common cancers, with the patients having stage 1 to 3 cancers—the only stages considered eligible for surgery at diagnosis.
Magnitude of the Delays
The increases in wait times were substantial across the cancers examined. For people with breast cancer (搜索), wait times increased from 34 days to 45 days. Gastric cancer (搜索) waits rose from 35 to 49 days, while those with colon cancer (搜索) waited between 20 to 31 days.
Disparities and Contributing Factors
Where patients were treated and other factors dictated whether or not they were impacted by longer wait times. The biggest waits were seen at large academic health centers. However, Black Americans, people who were uninsured or on Medicare, and patients who sought treatment in America's West were disproportionately affected.
The study's authors suggest multiple reasons for these delays. Staffing challenges and limited resources within facilities represent one factor. An increasing number of referrals from urgent care facilities and the increasing complexity of modern cancer care, including robotic surgeries, also contribute.
Notably, the study included surgeries conducted during the Covid-19 pandemic, when some cancer surgeries were pushed back. However, the researchers said they also saw a "noticeable increase" in waiting times post-Covid.
Clinical Consequences
These findings are concerning because longer wait times can raise the risk of disease spread and premature death, according to experts. Every month delayed in cancer treatment can raise the risk of death by around 10 percent, a past study from U.K. and Canada researchers showed. For every 30-day delay from the time of diagnosis, the risk of death increased by 4.6 percent, another study from The Ohio State University Wexner Medical Center determined.
"Many things are completely out of the medical team's control when caring for patients with head and neck cancer, but time to surgery is something we can immediately modify," head and neck cancer surgeon Dr. Stephen Kang said in a statement alongside the study's findings.