Radiation treatment waiting times for breast cancer patients in Manitoba, 2001 and 2005

Abstract

Introduction: Our study examined the wait time from ready-to-treat to radiation therapy for cohorts of breast cancer patients requiring adjuvant radiation therapy in 2001 and in 2005 after the implementation of strategies to reduce wait times for radiation treatment. We also examined the overall time from diagnosis to radiation treatment and whether distance from the cancer treatment centre or month of referral had an effect on wait times.

Methods: This population-based retrospective study looked at representative samples of women newly diagnosed with breast cancer in 2001 and 2005. Patients who required radiation treatment to the breast or chest wall were followed from first contact to the start of radiation treatment.

Results: Time from ready-to-treat to first radiation treatment was significantly reduced for patients in 2005 as compared with 2001, regardless of whether chemotherapy was administered before radiation treatment. Time from diagnosis to radiation treatment was not different by year for those who received radiation only. Time from diagnosis to chemotherapy was significantly longer in 2005. No effect of month of diagnosis on wait times was observed.

Interpretation: A significant improvement in the median wait time from ready-to-treat to first radiation treatment was noted from 2001 to 2005. This improvement may be attributable to measures taken to reduce such waits. However, we observed an increase in the median time from diagnosis to referral and from referral to consultation with medical or radiation oncology (or both), so that the overall time from diagnosis to radiation treatment was not different. Although specific intervals related to radiation treatment delivery were improved, the entire trajectory of breast cancer care experienced by patients needs to be considered.

Keywords: Breast cancer; radiation; wait times.

FIGURE 1

Comparison of 2001 and 2005 wait times for breast cancer patients along the trajectory of care. Intervals between breast cancer events are shown in median days, 2001 compared with 2005. For each pair of diamonds, the top diamond shows the 2001 mean elapsed days (25th–75th percentile), and the bottom diamond shows the 2005 median elapsed days (25th–75th percentile). Significant differences appear in the darker grey shade, and p values are adjusted for multiple testing. * Including mastectomy, partial mastectomy, and axillary dissection if carried out at separate times.