Robinson D, Massey T, Davies E, Jack R H, Sehgal A, Møller H
Thames Cancer Registry, Division of Cancer Studies, Guy's King's and St Thomas' School of Medicine, Capital House, 42 Weston Street, London SE1 3QD, UK.
Br J Cancer. 2005 Apr 11;92(7):1201-8. doi: 10.1038/sj.bjc.6602463.
The aim of this study was to investigate variations in the length of time that patients with cancer wait from diagnosis to treatment with radiotherapy. A total of 57,426 men and 71,018 women diagnosed with cancer between 1992 and 2001 and receiving radiotherapy within 6 months of diagnosis were identified from the Thames Cancer Registry database. In total, 12 sites were identified for which a substantial number or proportion of patients received radiotherapy: head and neck, oesophagus, colon, rectum, lung, nonmelanoma skin cancer, breast, uterus, prostate, bladder, brain and non-Hodgkin's lymphoma. Median waiting times from diagnosis to radiotherapy were calculated, together with the proportion of patients who received radiotherapy within 60 days of diagnosis, and analysed by year of diagnosis, cancer site, deprivation quintile, age at diagnosis, sex and cancer network of either residence or treatment. Logistic regression was used to adjust the proportion receiving treatment within 60 days for the effects of the other factors. There were significant differences in the proportions receiving radiotherapy within 60 days between different networks and different cancer sites, which remained after adjustment. Median waiting times varied from 42 to 65 days across networks of residence, with the adjusted proportion treated within 60 days ranging from 44 to 71%. There was no difference between male and female patients after adjustment for the other factors, particularly site. There was a highly significant trend over time: the median wait increased from 45 days in 1992 to 76 days in 2001, while the adjusted proportion being treated within 60 days declined by almost a half, from 64 to 35%, over the same period.
本研究的目的是调查癌症患者从确诊到接受放射治疗的等待时间的差异。从泰晤士癌症登记数据库中识别出1992年至2001年间共57426名男性和71018名女性癌症患者,他们在确诊后6个月内接受了放射治疗。总共确定了12个部位,有相当数量或比例的患者接受了放射治疗:头颈部、食管、结肠、直肠、肺、非黑色素瘤皮肤癌、乳腺、子宫、前列腺、膀胱、脑和非霍奇金淋巴瘤。计算了从确诊到放射治疗的中位等待时间,以及在确诊后60天内接受放射治疗的患者比例,并按确诊年份、癌症部位、贫困五分位数、确诊年龄、性别以及居住或治疗的癌症网络进行分析。使用逻辑回归调整在60天内接受治疗的比例,以考虑其他因素的影响。不同网络和不同癌症部位在60天内接受放射治疗的比例存在显著差异,调整后差异仍然存在。居住网络的中位等待时间从42天到65天不等,调整后在60天内接受治疗的比例从44%到71%不等。在调整其他因素,特别是部位后,男性和女性患者之间没有差异。随着时间的推移有一个非常显著的趋势:中位等待时间从1992年的45天增加到2001年的76天,而同期调整后在60天内接受治疗的比例下降了近一半,从64%降至35%。