Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Nov 19:11:9849-9861.
doi: 10.2147/CMAR.S221427. eCollection 2019.

Benefits Of Timely Care In Pancreatic Cancer: A Systematic Review To Navigate Through The Contradictory Evidence

Gábor Lukács  1   2 , Árpád Kovács  1   2 , Marcell Csanádi  3 , Mariann Moizs  1 , Imre Repa  1   2 , Zoltán Kaló  3   4 , Zoltán Vokó  3   4 , János György Pitter  3
Affiliations
Review

Benefits Of Timely Care In Pancreatic Cancer: A Systematic Review To Navigate Through The Contradictory Evidence

Gábor Lukács et al. Cancer Manag Res. .

Abstract

The evidence base of policies that improve the timeliness of cancer care is under ongoing debate. Pancreatic cancer is frequently diagnosed in a stage when curative therapy is not feasible; hence, it is an important target for timelier healthcare interventions. The objectives of our research were to identify all clinical studies on pancreatic cancer care delays via a systematic literature review, to assess the study methodologies for possible biases, to conclude on the available evidence, and to formulate research recommendations on evidence gaps. Nineteen studies were identified and eight reported multivariate analyses. Although many sources of bias shifted the results towards negative or paradoxical findings, a statistically significant association of shorter delays with better clinical outcomes was demonstrated in the majority of studies reporting multivariate analyses. Noninferiority analyses were not published. Further efforts to provide timely care for pancreatic cancer patients are encouraged, and studies on the associations of delay with patient experience and healthcare resource utilization are warranted.

Keywords: bias; delay; pancreatic cancer; prognosis; systematic review; wait time.

PubMed Disclaimer

Conflict of interest statement

The employers of the coauthors received public funding for qualitative and quantitative studies on a patient navigation program (OnkoNetwork) from the European Union’s Horizon 2020 Research and Innovation program under Grant Agreement No. 634288 (project acronym: SELFIE). Mr Marcell Csanádi report grants from Syreon Research Institute, during the conduct of the study; Dr Mariann Moizs report grants from Grant Agreement No. 634288 from the EU’s Horizon 2020 Research and Innovation Program, outside the submitted work; Professor Zoltán Kaló report grants from European Union’s Horizon 2020 Research and Innovation program, during the conduct of the study; Professor Zoltán Vokó report other from Syreon Research Institute, outside the submitted work; Dr János György Pitter report grants from European Union’s Horizon 2020 Research and Innovation program, outside the submitted work.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the systematic literature review.
Figure 2
Figure 2
Overview of key study findings and sources of potential methodological bias.
See this image and copyright information in PMC

References

    1. Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer. 2011;117(S15):3537–3540. doi:10.1002/cncr.v117.15s - DOI - PMC - PubMed
    1. Gorin SS, Haggstrom D, Han PKJ, et al. Cancer care coordination: a systematic review and meta-analysis of over 30 years of empirical studies. Ann Behav Med. 2017;51(4):532–546. doi:10.1007/s12160-017-9876-2 - DOI - PubMed
    1. Department of Health, The NHS Cancer Plan. 2000. Available from: http://webarchive.nationalarchives.gov.uk/20130222181549/http://www.dh.g... Accessed June6, 2019.
    1. Wilkens J, Thulesius H, Schmidt I, et al. The 2015 national cancer program in Sweden: introducing standardized care pathways in a decentralized system. Health Policy. 2016;120(12):1378–1382. doi:10.1016/j.healthpol.2016.09.008 - DOI - PubMed
    1. Sharpe D, Williams RN, Ubhi SS, et al. The “two-week wait” referral pathway allows prompt treatment but does not improve outcome for patients with oesophago-gastric cancer. Eur J Surg Oncol. 2010;36(10):977–981. doi:10.1016/j.ejso.2010.07.002 - DOI - PubMed