Department of Oncology, McMaster University, Hamilton, ON, Canada.
Gynecol Oncol. 2013 Oct;131(1):151-7. doi: 10.1016/j.ygyno.2013.06.036. Epub 2013 Jul 7.
Uterine cancer is a major cancer of women, with outcomes potentially worsening with delayed diagnosis or hysterectomy, the main treatment. Yet cancer surgery wait times are not reported by cancer site. This study sought to examine changes in wait times for uterine cancer surgery between 2000 and 2009 and to identify predictors of longer surgery wait times.
Population-based retrospective analysis of a cohort of uterine cancer patients diagnosed between April 2000 and March 2009. Using linked administrative data, all cases in which a patient had hysterectomy following diagnosis were identified. Wait time was defined as days from diagnosis of uterine cancer (day 0) to hysterectomy. Regression analysis was used to examine the relationship between covariates and wait time.
Wait times increased steadily between 2000 and 2006 from a median of 34 to 54 days, followed by a plateau until 2009-during which patients waited a median of between 53 and 55 days for surgery after diagnosis. Overall, 55% of patients had a wait time longer than 6 weeks after diagnosis. Predictors of a wait time greater than 6 weeks included older age, region, lower income, later year of diagnosis, surgery by a gynaecologic oncologist, non-sarcoma histology group and having surgery in a teaching hospital.
Over half of uterine cancer patients waited longer than the recommended 6 weeks for surgery. Future reporting of cancer wait times by each disease site regularly would help to identify progress to reduce wait times and opportunities for improvement.
子宫癌是女性的主要癌症之一，如果诊断延迟或进行子宫切除术（主要治疗方法），则可能会导致预后恶化。但是，癌症手术的等待时间并未按照癌症部位报告。本研究旨在调查 2000 年至 2009 年期间子宫癌手术等待时间的变化，并确定导致手术等待时间延长的预测因素。
对 2000 年 4 月至 2009 年 3 月间诊断出患有子宫癌的患者进行了基于人群的回顾性分析。使用链接的行政数据，确定了所有在诊断后接受子宫切除术的患者病例。等待时间定义为从诊断为子宫癌（第 0 天）到子宫切除术的天数。回归分析用于检查协变量与等待时间之间的关系。
2000 年至 2006 年期间，等待时间从 34 天的中位数稳步增加到 54 天，然后在 2009 年之前保持稳定，在此期间，诊断后患者等待手术的中位数在 53 至 55 天之间。总体而言，55％的患者等待时间超过诊断后 6 周。等待时间超过 6 周的预测因素包括年龄较大、所在地区、收入较低、诊断年份较晚、由妇科肿瘤学家进行手术、非肉瘤组织学组和在教学医院进行手术。
超过一半的子宫癌患者等待手术的时间超过了建议的 6 周。定期按照每个癌症部位报告癌症等待时间将有助于确定减少等待时间和改善机会的进展。
