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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Wait times from diagnosis to initial treatment increased between 2012 and 2023 for all six cancer types analyzed. The proportion of patients who waited at least 60 days also increased for all cancer types. Patients who need cancer surgery are waiting longer for initial therapy, according to results of a retrospective cohort study. The time between diagnosis and start of first-course treatment increased significantly between 2012 and 2023, findings showed.
Data derived from Sakowitz S, et al. JAMA Surg. 2026;doi:10.1001\/jamasurg.2026.3212.
The trends \u2014 observed for all six cancer types analyzed \u2014 appeared particularly pronounced for individuals treated at high-volume hospitals, as well as those referred for care. Timothy R. Donahue \u201cThe findings are alarming. The numbers are higher than we expected, and the fact they were consistent across all cancer types we looked at was particularly surprising,\u201d senior author Timothy R. Donahue, MD, told Healio. Comprehensive assessment Prior research that assessed the relationship between treatment delays and oncologic outcomes yielded conflicting results, according to study background. Still, guidance from several entities \u2014 including National Comprehensive Cancer Network and the Institute of Medicine \u2014 suggest timely access is a vital component of quality cancer care. Delivery of cancer treatment has evolved considerably over the past couple decades, with high-volume hospitals now providing a larger proportion of complex surgical care. Previous studies demonstrated advantages of receiving treatment at high-volume centers, including greater adoption of advanced multimodality therapies, fewer complications and longer survival. However, whether health system consolidation and the centralization of care has led to unintended consequences \u2014 such as capacity constraints or increased travel burdens for patients \u2014 that could cause delays between diagnosis and treatment had not been established. Donahue and colleagues aimed to perform the first comprehensive assessment of contemporary waiting times in cancer surgery care pathways in the United States. \u201cAs a cancer surgeon, I clearly see the benefits of consolidation and greater integration of health systems. However, I also see the potential inefficiencies and areas where there might be room for improvement,\u201d Donahue, chief of the division of surgical oncology at UCLA\u2019s David Geffen School of Medicine at the time of the study and currently chair of surgery at Weill Cornell Medicine and surgeon in chief at NewYork-Presbyterian\/Weill Cornell Medical Center, said in an interview. \u201cWe hypothesized that wait times might increase as health systems have consolidated and cancer care has become more complex and multidisciplinary.\u201d The researchers used the National Cancer Database to examine trends in waiting times from diagnosis of nonmetastatic cancer to first-course treatment among patients undergoing definitive cancer surgery. The analysis included 2.7 million adults (mean age, 63.5 years; 85% women) diagnosed with one of six stage I to stage III malignancies \u2014 breast, colon, esophageal, gastric, lung or pancreatic cancers \u2014 between 2012 and 2023 who underwent curative-intent surgical resection at American College of Surgeons Commission on Cancer-accredited hospitals. Time from diagnosis to first-course treatment \u2014 defined as upfront surgery or neoadjuvant therapy \u2014 served as the primary outcome. Consistent increases The percentage of patients with standard wait times \u2014 defined as less than 30 days \u2014 declined from 44% for those diagnosed in 2012-2015 to 25% for those diagnosed in 2022-2023. In contrast, the proportion with prolonged wait times \u2014 defined as 30 days or longer \u2014 increased from 56% to 75%. Median time from diagnosis to first-course treatment increased significantly (P < .001 for all) between 2012-2015 and 2022-2023 for individuals with all cancer types analyzed: breast cancer: 34 days (interquartile range [IQR], 22-50) to 45 days (IQR, 32-64); colon cancer: 20 days (IQR, 7-34) to 31 days (IQR, 15-49); esophageal cancer: 38 days (IQR, 27-54) to 48 days (IQR, 35-66); gastric cancer: 35 days (IQR, 21-51) to 49 days (IQR, 33-70); lung cancer: 41 days (IQR, 27-60) to 53 days (IQR, 35-77); and pancreatic cancer: 23 days (IQR, 14-35) to 32 days (IQR, 22-44). Wait times increased among patients who underwent upfront surgery and those who received neoadjuvant therapy. Results showed consistently longer delays for patients treated at academic or research institutions than community hospitals or integrated network programs. Among patients diagnosed in 2022-2023, investigators reported consistently shorter median waiting times at community hospitals than integrated network centers or academic institutions for breast cancer (43 days vs. 45 days vs. 49 days), colon cancer (28 days vs. 31 days vs. 35 days) and gastric cancer (46 days vs. 47 days vs. 51 days). In that same timeframe, results showed shorter wait times at integrated network programs than community programs or academic institutions for lung cancer (51 days vs. 53 days vs. 54 days), esophageal cancer (46 days vs. 47 days vs. 50 days) and pancreatic cancer (31 days vs. 32 days vs. 32 days). Patients referred for treatment experienced significantly longer waiting times to first-course treatment for all cancer types analyzed, with the longest waits among those referred to high-volume hospitals. Risk-adjusted analyses identified multiple other factors associated with longer wait times. Several of them \u2014 treatment at academic centers vs. community hospitals, treatment in the West or Northeast regions of the U.S. vs. the Midwest, higher comorbidity burden, lowest income quartile vs. highest income quartile, and more recent diagnosis year \u2014 remained consistent across all cancer types analyzed. Factors that predicted longer wait times for at least half of cancers analyzed included Medicaid insurance (five of six), Black race compared with white race (five of six), greater travel distance (four of six), and uninsured status vs. private insurance (three of six). Researchers also reported longer waiting times for patients with<\/p>\n","protected":false},"author":1,"featured_media":3535,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3534","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3534","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3534"}],"version-history":[{"count":0,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3534\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/media\/3535"}],"wp:attachment":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3534"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3534"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3534"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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