Waiting times for radiation therapy in Ontario.
BACKGROUND
The mass media and clinical journals have reported lengthy waiting times after surgery before initiation of radiation therapy (RT) for cancer across Canada. We aimed to describe the length of time between the last date of surgery or biopsy or chemotherapy and first date of RT.


METHODS
This is a population-based study measuring waiting times for RT in Ontario among all patients with potentially curable cancer of the cervix, tonsil and larynx and a random sample of women who had had breast cancer resection, whose first date of RT fell between Sept. 1, 2001, and Aug. 31, 2002. Abstraction of original health care records provided each patient's demographics, cancer stage and cancer treatment (last surgery, consultation, simulation, first RT). Last dates of chemotherapy before RT were obtained from abstraction or from Ontario Health Insurance Plan (OHIP) files, and last dates of surgery before RT were compared with dates in the Canadian Institute for Health Information (CIHI) Discharge Abstract Database.


RESULTS
Waiting times between the last date of surgery or chemotherapy and the first date of RT varied significantly among the health regions of Ontario. Increasing age, but not the presence of comorbidity, was associated with longer waiting times. Women who did not receive postoperative chemotherapy before RT for breast cancer waited significantly longer than all others.


CONCLUSIONS
Measurement of waiting times for cancer RT must discount time during which adjuvant intravenous chemotherapy is administered after surgery and before RT. There appears to be a formal or informal process by which those at highest risk begin RT most rapidly.
Benk
Veronique
V
Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ont.
Przybysz
Raymond
R
McGowan
Tom
T
Paszat
Lawrence
L
D000293:Adolescent; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D009864:Ontario; D012189:Retrospective Studies; D013997:Time Factors; D014067:Tonsillar Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D014850:Waiting Lists