Socio-demographic and other patient characteristics associated with time between colonoscopy and surgery, and choice of treatment centre for colorectal cancer: a retrospective cohort study
| Autor: | Ian N. Olver, Mark Harris, Michael Barton, Allan D. Spigelman, Dianne L. O'Connell, Shane W Pascoe, David Goldsbury |
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| Přispěvatelé: | Goldsbury, David, Harris, Mark Fort, Pascoe, Shane, Olver, Ian, Barton, Michael, Spigelman, Allan, O'Connell, Dianne |
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Design Treatment - Resources and Infrastructure analysis diagnosis Colorectal cancer Population Colonoscopy colorectal cancer Disease surgery Cohort Studies colonoscopy medicine cancer Cancer Type - Bowel & Colorectal Cancer Stage (cooking) education education.field_of_study Wales medicine.diagnostic_test business.industry Research Australia Health services research Cancer Retrospective cohort study General Medicine medicine.disease Surgery epidemiology Other Health Services Research New South Wales business |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2012-001070 |
| Popis: | Objectives To investigate key patient clinical and demographic characteristics associated with time between colonoscopy and surgery, and choice of treatment centre for colorectal cancer (CRC) patients. This will add to the little published research examining the pathway following CRC diagnosis and prior to surgery. Design Retrospective cohort analysis of linked data. Setting A population-based sample of people diagnosed August 2004 to December 2007 in New South Wales, Australia. Participants 569 CRC patients, of whom 407 (72%, 95% CI 68% to 75%) had colonoscopy followed by surgery. Primary outcome measures Time between colonoscopy and surgery, and whether the surgery took place in a specialist cancer centre. Results Among the 407 eligible patients analysed, the median time from colonoscopy to surgery was 19 days (IQR 12–29 days). After adjusting for key demographic and clinical characteristics such as age and disease stage, the time was longer for rectal cancer patients and those reporting fair/poor health, although differences in medians were Article summary Article focus Investigate key patient clinical and demographic characteristics associated with time between colonoscopy and surgery, and choice of treatment centre for colorectal cancer patients in New South Wales, Australia. Most existing research has focused on delay prior to diagnosis, and little is known about factors associated with referral to specialist treatment following diagnosis. Key messages Rectal cancer cases had slightly longer time to surgery than colon cancer cases. Treatment in a specialist cancer centre was associated more with patient access than disease characteristics. We need to ensure that those with the greatest need, such as those with rectal cancer, have access to timely and specialist treatment. Strengths and limitations of this study This is one of the first studies to examine the pathway following colorectal cancer diagnosis and prior to surgery, with a relatively large population-based sample of patients. Surgery was the only treatment we could reliably analyse. Surgeon specialties were not known so specialist centres were identified as institutions with radiotherapy facilities. We cannot determine the exact reason for longer time to treatment and it might actually be a positive, possibly reflecting referral to a specialist surgeon or preoperative radiotherapy. |
| Databáze: | OpenAIRE |
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