Management pathway for patients with cervical cancer in the Auckland region 2003-2007

Capelle, L; Stevens, Wendy; Brooks, Susan A.

doi:10.1111/j.1754-9485.2011.02276.x

Cited by 4 publications

(12 citation statements)

References 14 publications

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“…A shorter median time to FSA in the private sector was associated with a reduction in median duration of the overall pathway and was the only factor significantly associated with reduced times from referral to treatment initiation in the multivariable analysis. 38 Because our study was performed in the public sector only, our findings may reflect the patterns of health care use and the effectiveness of primary and secondary care services in Rio de Janeiro. Also, they may be a result of structural (geographic distance to the treatment facility and availability of transportation) 21 and nonstructural (individual patient and physician factors) 39,40 barriers.…”

Section: Discussionmentioning

confidence: 97%

Cervical Cancer Treatment Delays and Associated Factors in a Cohort of Women From a Developing Country

Silva

Koifman

2019

JGO

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PURPOSE To estimate treatment delays and associated factors among women diagnosed with cervical cancer who were treated at the main cancer center in Rio de Janeiro, Brazil. MATERIALS AND METHODS A retrospective cohort study was performed comprising 865 women newly diagnosed with cervical cancer between 2012 and 2014. Times from diagnosis to treatment initiation (less than or equal to 60 days) and from diagnosis to treatment ending (less than or equal to 120 days) were analyzed according to the Brazilian law for the treatment of patients with cancer. Associations between treatment delays and sociodemographic, economic, lifestyle, clinical, and treatment variables were estimated using logistic regression models, with 95% CIs. RESULTS The average age was 48 (± 13.7) years, and the median age was 47 years; 36.2% of patients had stage IIIB to IVA disease. The median time from diagnosis to treatment initiation was 114 days, which was statistically higher among women with stage IIB to IVA (105.5 days) compared with those with earlier stages (119 days). The delay in treatment initiation occurred in 92.8% of participants; the median time from diagnosis to treatment ending was 274 days, with a delay (more than 120 days) for 92.6% of patients. The median time interval from diagnosis to the first visit to the cancer center was 28 days, with a delay of more than 30 days for 46.6% of patients. Age (odds ratio [OR], 1.05; 95% CI,1.02 to 1.08), stage IIIB to IVA (OR, 0.38; 95% CI, 0.16 to 0.90), time to first visit to the cancer center (OR, 11.52; 95% CI, 4.32 to 30.66), chemoradiation treatment (OR, 4.56; 95% CI, 1.81 to 11.47), and adequate treatment (OR, 2.57; 95% CI, 1.26 to -5.40) were independently associated with delay of treatment initiation. CONCLUSION Significant delays in treatment initiation and ending were observed in this studied population. The treatment initiation delay was positively associated with age, time interval more than 30 days from diagnosis to first specialist assessment at the cancer center, treatment with chemoradiation, and adequate treatment.

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Section: Discussionmentioning

confidence: 97%

Cervical Cancer Treatment Delays and Associated Factors in a Cohort of Women From a Developing Country

Silva

Koifman

2019

JGO

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“…More recently (2003 to 2007), cases of the same type, which were diagnosed in Auckland, New Zealand, had a median of 26 days counting from the time of the decision to treat the disease up to the ionizing therapy being administered. 5 …”

Section: Discussionmentioning

confidence: 99%

“…Casos do mesmo tipo diagnosticados mais recentemente (2003 a 2007) em Auckland, Nova Zelândia, tiveram mediana de 26 dias contados da data de decisão de tratar até a administração da terapia ionizante. 5 …”

Section: Discussionunclassified

Waiting time for radiotherapy in women with cervical cancer

Nascimento

Silva

2015

Rev. Saúde Pública

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OBJECTIVE To describe the waiting time for radiotherapy for patients with cervical cancer.METHODS This descriptive study was conducted with 342 cervical cancer cases that were referred to primary radiotherapy, in the Baixada Fluminense region, RJ, Southeastern Brazil, from October 1995 to August 2010. The waiting time was calculated using the recommended 60-day deadline as a parameter to obtaining the first cancer treatment and considering the date at which the diagnosis was confirmed, the date of first oncological consultation and date when the radiotherapy began. Median and proportional comparisons were made using the Kruskal Wallis and Chi-square tests.RESULTS Most of the women (72.2%) began their radiotherapy within 60 days from the diagnostic confirmation date. The median of this total waiting time was 41 days. This median worsened over the time period, going from 11 days (1995-1996) to 64 days (2009-2010). The median interval between the diagnostic confirmation and the first oncological consultation was 33 days, and between the first oncological consultation and the first radiotherapy session was four days. The median waiting time differed significantly (p = 0.003) according to different stages of the tumor, reaching 56 days, 35 days and 30 days for women whose cancers were classified up to IIA; from IIB to IIIB, and IVA-IVB, respectively.CONCLUSIONS Despite most of the women having had access to radiotherapy within the recommended 60 days, the implementation of procedures to define the stage of the tumor and to reestablish clinical conditions took a large part of this time, showing that at least one of these intervals needs to be improved. Even though the waiting times were ideal for all patients, the most advanced cases were quickly treated, which suggests that access to radiotherapy by women with cervical cancer has been reached with equity.

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“…This investigation became more accessible and was part of the management protocol essential to determine extent of disease and decision on treatment modality. This helped to improve the median time from FSA to completion of radiological staging from 48 to 35 days. However, this clearly shows that access to imaging is still a problem and contributes significantly to the waiting time and further improvements need to be made here.…”

Section: Discussionmentioning

confidence: 99%

“…This study was initiated to assess whether the changes implemented following the previous audit carried out between 2003 and 2007 resulted in improvement of the delivery of care to women with cervical cancer in the Auckland/Northland regions. Recent years have seen a reduction in cervical cancer mortality rate, and this reduction may be associated with improved socio‐economic condition, better screening and improvement in treatment delivery .…”

Section: Introductionmentioning

confidence: 99%

A retrospective audit of treatment pathway for women diagnosed with cervical cancer in the Auckland region 2012–2016

Parinpanayagam

Brooks

2019

J Med Imag Rad Onc

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Introduction: The purpose of this study was to describe the treatment pathway and timelines of patients diagnosed with FIGO stage IB1-IVA cervical cancer receiving definitive radiotherapy +/À chemotherapy and the potential improvements made since the previous audit and impact on overall survival (OS), disease-free survival (DFS) and local control (LC). Methods: This is a retrospective audit on patients diagnosed with FIGO Stage 1B1-IVA cervical cancer in the Northland/Auckland region of New Zealand between 2012 and 2016. Results: There were 95 patients identified. Median time from referral to start of treatment was 69 days, from referral to first specialist assessment (FSA) 11 days, from FSA to decision to treat (DTT) 41 days and from DTT to start treatment 21 days. There was no statistical difference in time from referral to start of treatment between patients treated with radiotherapy alone or with combined chemoradiotherapy (P < 0.1695). Private FSA (P < 0.0115) and shorter time from MDM to completion of radiological investigations (P < 0.0001) were associated with shorter median times from referral to start of treatment. Median overall treatment time (OTT) was 43 days. The 3-year OS, LC and DFS were all 100% for Stage IB, 78%, 95% and 78% for Stage II, 79%, 88% and 77% for Stage III and 58%, 57% and 43% for Stage IV. Conclusion: There has been some overall improvement in the treatment pathways, and OTT was less than the recommended 8 weeks. Our 3-year OS, LC and DFS were comparable with international standards.

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Management pathway for patients with cervical cancer in the Auckland region 2003-2007

Abstract: Overall patient pathway and radiotherapy OTT were longer than optimal, and areas of delay potentially amenable to modification were identified.

Cited by 4 publications

References 14 publications

Cervical Cancer Treatment Delays and Associated Factors in a Cohort of Women From a Developing Country

Cervical Cancer Treatment Delays and Associated Factors in a Cohort of Women From a Developing Country

Waiting time for radiotherapy in women with cervical cancer

A retrospective audit of treatment pathway for women diagnosed with cervical cancer in the Auckland region 2012–2016

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