title: Predictors of delay in starting radiation treatment for patients with early stage breast cancer.
abstract: OBJECTIVE
  To describe the factors predicting waiting time for radiation treatment in early breast cancer.
  
  
  METHODS
  Between January 1992 and December 1993, 739 patients with Stage I and II breast cancer were treated with conservative treatment at three McGill University Hospitals. Waiting time was defined as the interval between the date of surgery and the date of the first radiation treatment. Delay was defined as a waiting time of more than 7 weeks for women who did not receive chemotherapy (Group NC, n = 478), and as a waiting time of more than 24 weeks for those who received chemotherapy (Group C, n = 261). We analyzed predictive factors related to the patient (age, stage, treatment on protocol, income by postal code) and to the referring hospital (university or community hospital).
  
  
  RESULTS
  For the entire population, 54% of patients were delayed, 72% in Group NC and 21.4% in Group C. Univariate analysis showed an impact of referring hospital in both groups, and of stage and treatment on protocol in Group C (all p = 0.001). Multivariate analysis showed that delays were significantly less in Group NC for women referred from a community hospital (p = 0.001) and in Group C for women with Stage I disease (p = 0.06), those treated on protocol, and those referred from a university hospital (p = 0.001).
  
  
  CONCLUSIONS
  More than half of patients with early breast cancer waited more than the recommended intervals for radiation therapy. However, lower income breast cancer patients did not wait longer for treatment than higher income patients, possibly a result of the Canadian Medicare system which provides universal access to health care.
authors.affiliation: Montreal General Hospital, Department of Oncology, McGill University, Quebec, Canada.
authors.forename: V
authors.initials: V
authors.lastname: Benk
authors.forename: V
authors.initials: V
authors.lastname: Ho
authors.forename: P R
authors.initials: PR
authors.lastname: Fortin
authors.forename: G
authors.initials: G
authors.lastname: Zhang
authors.forename: C
authors.initials: C
authors.lastname: Levinton
authors.forename: C R
authors.initials: CR
authors.lastname: Freeman
mesh_terms: D000704:Analysis of Variance; D001071:Appointments and Schedules; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D013997:Time Factors