Surgical wait times for patients with urological cancers: a survey of Canadian surgeons.
BACKGROUND
The wait times for urological cancer surgeries in Canada has increased over the past 2 decades. This is of concern to patients, physicians and other key stakeholders because there is evidence that delaying surgery beyond a recommended threshold could have a negative impact on clinical outcomes. To address these trends, a Canadian surgical wait times (SWAT) initiative has been undertaken to develop a consensus document and make recommendations on appropriate wait times. As a first step, the SWAT steering committee determined that current wait times estimates were required for the four key disease sites; prostate, bladder, kidney and testes. To obtain such data, a survey of Canadian urological surgeons was undertaken.


METHODS
A structured electronic mailing strategy was adopted as recommended by Dillman (1978). Standardized data collection forms were sent to members of the Canadian Urological Association (CUA) and attendees to the 2005 CUA meeting. Survey items consisted of respondent demographic data, information on surgical wait times for the four key disease sites and potential barriers to timely cancer surgery.


RESULTS
One hundred and five urological surgeons responded to the survey. There was considerable variation in wait times between and within the four disease sites with bladder and kidney cancer surgeries displaying the widest range. Operating room availability and staging tests were identified as the most significant barriers to efficient cancer surgery.


CONCLUSIONS
The wide variation in wait times identified in this study suggest that the overall time to treatment from referral is beyond the duration considered by many experts and by the Canadian Society of Surgical Oncology to be acceptable. These issues need to be addressed through a partnership between the key stakeholders in order to reduce the potentially negative impact on clinical outcomes and patient quality of life.
Fleshner
Neil
N
University of Toronto, Princess Margaret Hospital, Toronto, Ontario, Canada.
Dranitsaris
George
G
Finelli
Antonio
A
Tsihlias
John
J
Bell
David
D
Gleave
Martin
M
D001071:Appointments and Schedules; D002170:Canada; D003625:Data Collection; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D008297:Male; D009367:Neoplasm Staging; D009873:Operating Rooms / Q000600:supply & distribution; D011471:Prostatic Neoplasms / Q000601:surgery; D013736:Testicular Neoplasms / Q000601:surgery; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014571:Urologic Neoplasms / Q000601:surgery*