Comparison of wait times across the breast cancer treatment pathway among screened women undergoing organized breast assessment versus usual care.

Autor: Blackmore KM; Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada., Weerasinghe A; Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada., Holloway CMB; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.; Department of Surgery, University of Toronto, 149 College Street, 5th Floor, Toronto, Ontario, M5T 1P5, Canada., Majpruz V; Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada., Mirea L; Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA.; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada., O'Malley FP; Department of Laboratory Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada., Paroschy Harris C; Prevention and Screening Services, Thunder Bay Regional Health Sciences Centre, 980 Oliver Road, Thunder Bay, Ontario, P7B 6V4, Canada., Hendry A; South East Regional Cancer Program, 25 King Street, West Kingston, Ontario, K7L 5P9, Canada., Hey A; North East Regional Cancer Program, 41 Ramsey Lake Road, Sudbury, ON, P3E 5J1, Canada., Kornecki A; South West Regional Cancer Program, 790 Commissioners Road, East London, Ontario, N6A 4L6, Canada., Lougheed G; North Simcoe Muskoka Regional Cancer Program, 201 Georgian Drive, Barrie, ON, L4M 6M2, Canada., Maier BA; Waterloo Wellington Regional Cancer Program, 835 King Street, West Kitchener, Ontario, N2G 1G3, Canada., Marchand P; Central East Regional Cancer Program, 1 Hospital Court, Oshawa, Ontario, L1G 2B9, Canada., McCready D; Department of Surgery, University of Toronto, 149 College Street, 5th Floor, Toronto, Ontario, M5T 1P5, Canada.; Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada., Rand C; Hamilton Niagara Haldimand Brant Regional Cancer Program, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada., Raphael S; North York General Hospital, 4001 Leslie St., North York, Ontario, M2K 1E1, Canada., Segal-Nadler R; Champlain Regional Cancer Program, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada., Sehgal N; Erie St. Clair Regional Cancer Program, 2220 Kildare Road, Windsor, Ontario, N8W 2X3, Canada., Muradali D; Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada.; St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada.; Department of Medical Imaging, University of Toronto, 263 McCaul Street, 4th Floor, Toronto, Ontario, M5T 1W7, Canada., Chiarelli AM; Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada. anna.chiarelli@cancercare.on.ca.; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada. anna.chiarelli@cancercare.on.ca.
Jazyk: angličtina
Zdroj: Canadian journal of public health = Revue canadienne de sante publique [Can J Public Health] 2019 Oct; Vol. 110 (5), pp. 595-605. Date of Electronic Publication: 2019 Apr 29.
DOI: 10.17269/s41997-019-00210-7
Abstrakt: Objective: The benefit of organized breast assessment on wait times to treatment among asymptomatic women is unknown. The Ontario Breast Screening Program (OBSP) offers screening and organized assessment through Breast Assessment Centres (BAC). This study compares wait times across the treatment pathway among screened women diagnosed with breast cancer through BAC and usual care (UC).
Methods: A retrospective design identified two concurrent cohorts of postmenopausal women aged 50-69 within the OBSP diagnosed with screen-detected invasive breast cancer and assessed in BAC (n = 2010) and UC (n = 1844) between 2002 and 2010. Demographic characteristics were obtained from the OBSP. Medical chart abstraction provided prognostic and treatment data. Multinomial logistic regression examined associations of assessment type with wait times from abnormal mammogram to surgery, chemotherapy or radiotherapy.
Results: Compared with through UC, postmenopausal women diagnosed through BAC were significantly less likely to have longer wait times (days) from an abnormal mammogram to definitive surgery (> 89 vs. ≤ 47; OR = 0.63; 95% CI = 0.52-0.77), from final surgery to radiotherapy (> 88 vs. ≤ 55; OR = 0.71; 95% CI = 0.54-0.93) and from final chemotherapy to radiotherapy (> 41 vs. ≤ 28; OR = 0.52; 95% CI = 0.36-0.76). Conversely, women assessed through BAC compared with through UC were more likely to experience longer wait times from final surgery to chemotherapy (> 64 vs. ≤ 40; OR = 1.49; 95% CI = 1.04-2.14).
Conclusion: Shorter wait times to most treatments for postmenopausal women diagnosed in BAC further supports that women with an abnormal mammogram should be managed through organized assessment. Continued evaluation of factors influencing wait times to treatment is essential for quality improvement and patient outcomes.
Databáze: MEDLINE
Externí odkaz: