title: Waiting times in early-stage non-small cell lung cancer (NSCLC).
abstract: BACKGROUND
  Wait times in cancer care continue to be an important clinical, social, and political issue. This study examines wait times along the care path from suspicious imaging study (Detection) to adjuvant chemotherapy initiation (Chemotherapy) for patients with early-stage non-small cell lung cancer (NSCLC) who undergo surgical resection.
  
  
  METHODS
  A retrospective chart review of patients diagnosed in 2005 with NSCLC who underwent curative-intent surgery in Nova Scotia, Canada was conducted to abstract dates of care events (Detection, Surgery Consultation, Surgery, Medical Oncology [MO] Referral, MO Consultation and Chemotherapy) and patient characteristics. Multifactorial regression methods were used to identify statistically-significant cofactors associated with wait times at various resolutions of care intervals (low, intermediate, high).
  
  
  RESULTS
  A median wait time of 141 days elapsed between Detection-Chemotherapy; and a median 107 and 52 days elapsed between Detection-Surgery and Surgery-Chemotherapy, respectively. A number of demographic, clinical, epidemiological, and system resource dependant factors influenced wait times at different resolutions, and were best detailed utilizing high resolution analysis. Wait time between MO referral-MO Consultation was inversely related to that experienced in the preceding interval of Surgery-MO Referral.
  
  
  CONCLUSIONS
  This study provides a first detailed examination of wait times experienced by NSCLC patients undergoing curative-intent surgery according to care interval definitions; demonstrates the value of high care interval resolution analysis to detect bottlenecks in access to care; and reports on the interdependence of elapsed times between care events along the care path for cancer patients.
authors.affiliation: Surveillance and Epidemiology Unit, Cancer Care Nova Scotia, Halifax, NS, Canada. nathalie.st-jacques@ccns.nshealth.ca
authors.forename: Nathalie
authors.initials: N
authors.lastname: Saint-Jacques
authors.forename: Daniel
authors.initials: D
authors.lastname: Rayson
authors.forename: Turki
authors.initials: T
authors.lastname: Al-Fayea
authors.forename: Kiran
authors.initials: K
authors.lastname: Virik
authors.forename: Wojciech
authors.initials: W
authors.lastname: Morzycki
authors.forename: Tallal
authors.initials: T
authors.lastname: Younis
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012907:Smoking; D013997:Time Factors; D014850:Waiting Lists