Waiting times for cancer patients in Sweden: A nationwide population-based study

Robertson, Stephanie; Adolfsson, Jan; Stattin, Pär; Sjövall, Annika; Winnersjö, Rocio; Hanning, Marianne; Sandelin, Kerstin

doi:10.1177/1403494817693695

Cited by 19 publications

(22 citation statements)

References 13 publications

(16 reference statements)

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“…Studies based on cancer registries comparing time from diagnosis to treatment between different cancer forms have also been published [20, 21]. An enquiry commissioned by the Ministry of Health and Welfare on, waiting times for diagnosis and treatment derived from three Swedish quality registers found large variations between the different diagnoses breast, colorectal and prostate cancers [22].…”

Section: Discussionmentioning

confidence: 99%

Validation of data quality in the Swedish National Register for Breast Cancer

et al. 2019

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Background The National Breast Cancer Register (NBCR) of Sweden was launched in 2008 and is used for quality assurance, benchmarking, and research. Its three reporting forms encompass Notification, Adjuvant therapy and Follow-up. Target levels are set by national and international guidelines. This national validation assessed data quality of the register. Methods Data recorded through the Notification form were evaluated for completeness, timeliness, comparability and validity. Completeness was assessed by cross-linkage to the Swedish Cancer Register (SCR). Comparability was analyzed by comparing registration routines in NBCR with national and international guidelines. Timeliness was defined as the difference between the earliest date of diagnosis and the reporting date to NBCR. Validity was assessed by re-abstraction of medical chart data for 800 randomly selected patients diagnosed in 2013. Results The completeness of the NBCR was high with a coverage across regions and years (2010–2014) of 99.9%. Of all incident cases reported to the NBCR in 2013 ( N = 8654), 98.5% were included within 12 months and differences between health regions were essentially negligible. Coding procedures followed guidelines and were uniformly adhered to. The proportion of missing values was < 5% for most variables and reported information generally had high exact agreement (> 90%). Conclusions Completeness of data, comparability and agreement in the NBCR was high. For clinical quality purposes and benchmarking, improved timeliness is warranted. Assessment of validity has resulted in a thorough review of all variables included in the Notification form with clarifications and revision of selected variables.

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Section: Discussionmentioning

confidence: 99%

Validation of data quality in the Swedish National Register for Breast Cancer

et al. 2019

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“…Patients affected by serious illness and chronic disease may experience delayed diagnoses and have to wait longer than medically desired in favor of CPP patients. The same applies for those patients whose cancer relapses and patients considered to be of lower priority [4, 8, 9, 22].…”

Section: Discussionmentioning

confidence: 99%

“…For Sweden, a country with one of the highest survival rates in the world, no major improvements in waiting times for patients in cancer care have been found during recent years. Furthermore, great differences, both between and within geographical areas, cancer forms, and sex, have been found [4–6].…”

Section: Introductionmentioning

confidence: 99%

Implementing standardized cancer patient pathways (CPPs) – a qualitative study exploring the perspectives of health care professionals

Delilovic

Hasson

Åhström

et al. 2019

BMC Health Serv Res

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Background Many countries have implemented standardized cancer patient pathways (CPPs) to reduce waiting times in cancer care and to ensure timely and quick diagnosis as well as treatment. Yet, no studies have explored the implementation process as perceived by the health care professionals working in the CPPs. The aim of this study is to explore the experiences of health care professionals (HPCs) involved in the CPPs. Methods A descriptive qualitative design was adopted. Thematic analysis was applied to individual interviews conducted in 2016–2017 with 58 participants working in six different CPPs in Sweden’s largest region, covering care for around 2.3 million inhabitants. Results In general, the health care professionals had a positive attitude towards the implementation of the CPPs. Our findings showed that the CPPs require close collaboration, both between and within different health care professional groups and units, something that was not always probable due to differences in resource capacity. Better dissemination to all relevant professionals, better conceptualization, and equivalent opportunities in terms of resources were identified by the respondents as being important yet lacking in practice. The analysis showed possible negative effects of the CPP, such as crowding-out on other patient groups. Conclusion The CPPs were introduced to address challenges with long waiting times and unequal cancer care. By exploring the experiences of health care professionals involved in the implementation of CPPs, our findings show challenges with multi-level coordination and collaboration, policy dissemination, and resource constraints. The analysis also showed that the implementation of CPPs risk being accompanied by unintended effects such as longer waiting times for other patients and patient groups in need of the same health care resources. The results shed light on and contribute to an understanding of the challenges, opportunities and ways forward.

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“…Quality assurance activities utilising RWD from NPCR include assessment of guideline compliance and their impact on practice [ 77 , 78 , 79 ], reporting of quality indicators [ 80 , 81 ] and rapid feedback on performance to healthcare providers [ 82 ]. For example, Robertson et al [ 81 ] assessed waiting times from referral to initiation of curative treatment for breast, colorectal and prostate cancer from several clinical cancer registers, including the NPCR. Men with PCa had by far the longest waiting times, varying from 117 to 280 days across regions, emphasising the need for improved care pathways to facilitate more rapid diagnosis and treatment.…”

Section: The Value Of Rwd In Understanding Pca—examples From Swedimentioning

confidence: 99%

The Value of Real-World Data in Understanding Prostate Cancer Risk and Improving Clinical Care: Examples from Swedish Registries

Beckmann

Garmo

Lissbrant

et al. 2021

Cancers

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Real-world data (RWD), that is, data from sources other than controlled clinical trials, play an increasingly important role in medical research. The development of quality clinical registers, increasing access to administrative data sources, growing computing power and data linkage capacities have contributed to greater availability of RWD. Evidence derived from RWD increases our understanding of prostate cancer (PCa) aetiology, natural history and effective management. While randomised controlled trials offer the best level of evidence for establishing the efficacy of medical interventions and making causal inferences, studies using RWD offer complementary evidence about the effectiveness, long-term outcomes and safety of interventions in real-world settings. RWD provide the only means of addressing questions about risk factors and exposures that cannot be “controlled”, or when assessing rare outcomes. This review provides examples of the value of RWD for generating evidence about PCa, focusing on studies using data from a quality clinical register, namely the National Prostate Cancer Register (NPCR) Sweden, with longitudinal data on advanced PCa in Patient-overview Prostate Cancer (PPC) and data linkages to other sources in Prostate Cancer data Base Sweden (PCBaSe).

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Waiting times for cancer patients in Sweden: A nationwide population-based study

Abstract: Large variations were found in waiting times between different counties in Sweden and between different types of cancer. The long waiting times identified in this study emphasize the need to improve national programmes for more rapid diagnosis and treatment.

Cited by 19 publications

References 13 publications

Validation of data quality in the Swedish National Register for Breast Cancer

Validation of data quality in the Swedish National Register for Breast Cancer

Implementing standardized cancer patient pathways (CPPs) – a qualitative study exploring the perspectives of health care professionals

The Value of Real-World Data in Understanding Prostate Cancer Risk and Improving Clinical Care: Examples from Swedish Registries

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