法国结肠癌或直肠癌患者结肠镜检查后至首次治疗的时间。

Time to first treatment after colonoscopy in patients suffering from colon or rectum cancer in France.

作者信息

Kudjawu Yao Cyril, Eilstein Daniel, Decool Elsa, De Maria Florence, Beltzer Nathalie, Chatellier Gilles

机构信息

Institut de veille sanitaire, département des maladies chroniques et traumatismes, 12, rue du Val d'Osne, 94414 Saint-Maurice, France.

Institut de veille sanitaire, direction scientifique et de la qualité, 12, rue du Val d'Osne, 94414 Saint-Maurice, France.

出版信息

Cancer Epidemiol. 2015 Dec;39(6):877-84. doi: 10.1016/j.canep.2015.10.002. Epub 2015 Nov 9.

DOI:10.1016/j.canep.2015.10.002

PMID:26651450

Abstract

BACKGROUND

Time to treatment of cancer is becoming a serious political and social issue. A greater understanding of the timeframes involved in cancer care is needed to reduce inequalities in access to care caused by delays.

OBJECTIVE

To describe indicators of time to first treatment after colonoscopy in colon cancer (CC) and rectum cancer (RC) patients in France.

METHOD

Using the international classification of diseases and medical procedures codes, from national hospital discharge and long term illness databases we selected patients newly diagnosed for CC or RC in 2009-2010 who had undergone treatment.

RESULTS

We included 15 694 and 6 623 patients for CC and RC, respectively. Median times to surgery in patients with a surgical treatment pathway for CC and RC were 22 (Q1=14; Q3=34) and 97 (Q1=34; Q3=141) days, respectively. Median times to chemotherapy for patients with a non-surgical treatment pathway, for CC and RC were 36 (Q1=21; Q3=59) and 40 (Q1=27; Q3=59) days, respectively. The median time to radiotherapy in RC patients was 53 (Q1=39; Q3=78) days.Time to surgery as first treatment in RC patients (46 days) was twice as long as that in CC patients (22 days). Time to treatment was longer in most northern regions and in overseas districts, and shorter in southern regions, for both CC and RC.

CONCLUSION

The findings in this unprecedented study in France will inform decision-making policies on the future implementation of guidelines on timeframes for colorectal cancer treatment access.

摘要

背景

癌症治疗时机正成为一个严重的政治和社会问题。为减少因延误导致的医疗服务获取不平等现象，需要更深入了解癌症治疗所涉及的时间框架。

目的

描述法国结肠癌（CC）和直肠癌（RC）患者结肠镜检查后首次治疗时间的指标。

方法

利用疾病和医疗程序国际分类编码，从国家医院出院和长期疾病数据库中，我们选取了2009 - 2010年新诊断为CC或RC且接受过治疗的患者。

结果

我们分别纳入了15694例CC患者和6623例RC患者。CC和RC采用手术治疗路径的患者手术中位时间分别为22天（Q1 = 14；Q3 = 34）和97天（Q1 = 34；Q3 = 141）。CC和RC采用非手术治疗路径的患者化疗中位时间分别为36天（Q1 = 21；Q3 = 59）和40天（Q1 = 27；Q3 = 59）。RC患者放疗中位时间为53天（Q1 = 39；Q3 = 78）。RC患者作为首次治疗的手术时间（46天）是CC患者（22天）的两倍。CC和RC患者在大多数北部地区和海外地区治疗时间较长，而在南部地区较短。