Original Title: Evaluación de los tiempos de atención del cáncer en las principales localizaciones: colon-recto, pulmón, mama y próstata

Authors' objectives: To improve the validity of times to diagnosis for cancer at the four main locations for this disease. To compare the times from first suspicion to first treatment, as calculated using the current method, with those obtained after reviewing the process and determining the optimal date of first suspicion.

Authors' results and conclusions: A total of 359 neoplasms with a primary location in the colon/rectum, 396 in the lung, 320 in the breast and 377 in the prostate were analysed. The time between the first contact with the healthcare system and diagnosis and treatment is higher than the time from date of suspicion currently used for all four locations: Time to diagnosis: Colorectal: 23 vs. 4 days; lung: 22 vs. 10 days; breast: 24 vs. 8 days; prostate: 110 vs. 29 days. Time to treatment colorectal: 55 vs. 31 days; lung: 55 vs. 40 days; breast: 50 vs. 35.5 days; prostate: 183 vs. 107.5 days. These differences are maintained irrespective of the route by which the patient entered the system and the existence of follow-up, except for breast cancer, for which access via A&E does not exhibit any significant differences. The time between the date on which the first test was requested and diagnosis and treatment is higher than the time from date of suspicion currently used for all four locations: Time to diagnosis: Colorectal: 9 vs. 4 days; lung: 13 vs. 10 days; breast: 14 vs. 8 days; prostate: 93 vs. 29 days. Time to treatment colorectal: 38 vs. 31 days; lung: 42 vs. 40 days; breast: 42 vs. 35.5 days; prostate: 181.5 vs. 107.5 days. These differences are also observed irrespective of the existence of follow-up for all four locations. However, with regard to the route of entry, significant differences were only found for lung cancer patients who entered via A&E. CONCLUSIONS The results of this study show that the «date of first contact with the healthcare system» and the «date on which the test that leads to diagnosis was requested» provide a more realistic view of the cancer care process than the date of suspicion currently collected. The collection of these dates from healthcare information systems must be improved. Larger studies are required to assess the influence of variables such as access via A&E or the existence of follow-up on cancer care times.

Authors' methods: A systematic literature review to determine which dates or care periods are considered when measuring care delays for cancer patients. A retrospective study of cancer cases at the highest incidence locations (colon/rectum, lung, breast and prostate) diagnosed in 2006 in the Autonomous Community of the Basque Country and registered in the database of the Hospital-Based Cancer Registries of the Basque Health Service (Osakidetza). Inclusion criteria: older than 19 years and younger than 80 years, cases diagnosed in 2006, cases with primary diagnosis at the hospital, primary treatment at the hospital or diagnosis and primary treatment at the hospital. The study variables included information concerning the patient, the tumour and contact dates with the healthcare system. The sources used to obtain information not available in these registries included the healthcare information systems of Osakidetza, Osabide AP, and Osabide and Global. A new variable, namely «Date of first contact with the healthcare system», either in A&E, primary care or specialised care, was created from those collected. The data were analysed using the program IBM SPSS Statistics 19. Non-parametric tests were used as the time variable does not follow a normal distribution. The Wilcoxon signed rank test for related samples was used to compare the medians for the times, with the median test being used for independent samples.

Project Status: Completed

Year Published: 2016

URL for published report: https://www.ogasun.ejgv.euskadi.eus/r51-catpub/es/k75aWebPublicacionesWar/k75aObtenerPublicacionDigitalServlet?R01HNoPortal=true&N_LIBR=051878&N_EDIC=0001&C_IDIOM=es&FORMATO=.pdf

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>