Department of Registration, Cancer Registry of Norway, Oslo, Norway.
Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway.
Cancer Epidemiol. 2019 Aug;61:59-69. doi: 10.1016/j.canep.2019.05.004. Epub 2019 May 27.
In 2015, Norway implemented cancer patient pathways to reduce waiting times for treatment. The aims of this paper were to describe patterns in waiting time and their association with patient characteristics for colorectal, lung, breast and prostate cancers.
National, population-based data from 2007 to 2016 were used. A multivariable quantile regression examined the association between treatment period, age, stage, sex, place of residence, and median waiting times.
Reduction in median waiting times for radiotherapy among colorectal, lung and prostate cancer patients ranged from 14 to 50 days. Median waiting time for surgery remained approximately 21 days for both colorectal and breast cancers, while it decreased by 7 and 36 days for lung and prostate cancers, respectively. The proportion of lung and prostate cancer patients with metastatic disease at the time of diagnosis decreased, while the proportion of colorectal patients with localised disease and patients with stage I breast cancer increased (p < 0.001). After adjusting for case-mix, a patient's place of residence was significantly associated with waiting time for treatment (p < 0.001), however, differences in waiting time to treatment decreased over the study period.
Between 2007 and 2016, Norway experienced improved stage distributions and consistently decreasing waiting times for treatment. While these improvements occurred gradually, no significant change was observed from the time of cancer patient pathway implementation.
2015 年，挪威实施了癌症患者路径，以减少治疗的等待时间。本文的目的是描述等待时间的模式及其与结直肠癌、肺癌、乳腺癌和前列腺癌患者特征的关联。
使用了 2007 年至 2016 年的全国性、基于人群的数据分析。多变量分位数回归分析了治疗期、年龄、分期、性别、居住地与中位等待时间之间的关系。
结直肠癌、肺癌和前列腺癌患者的放疗中位等待时间减少了 14 至 50 天。结直肠癌和乳腺癌的手术中位等待时间仍保持在大约 21 天，而肺癌和前列腺癌的手术中位等待时间分别减少了 7 天和 36 天。诊断时患有转移性疾病的肺癌和前列腺癌患者比例下降，而患有局部疾病的结直肠癌患者和患有 I 期乳腺癌的患者比例上升（p<0.001）。在调整病例组合后，患者的居住地与治疗等待时间显著相关（p<0.001），但治疗等待时间的差异在研究期间逐渐缩小。
在 2007 年至 2016 年间，挪威的分期分布有所改善，治疗的等待时间持续缩短。虽然这些改进是逐渐发生的，但从癌症患者路径实施的时间来看，没有观察到显著的变化。
