title: Wait times from presentation to treatment for colorectal cancer: a population-based study.
abstract: BACKGROUND
  The wait time from cancer diagnosis to treatment has been a recent focus of cancer care in Canada.
  
  
  OBJECTIVE
  To examine the trends in wait times from patient presentation to treatment (overall health system wait time [OWT]) for colorectal cancer (CRC).
  
  
  METHODS
  Patients with colorectal adenocarcinomas, diagnosed between 2001 and 2005, and their first definitive treatments were identified from the population-based Manitoba Cancer Registry (Winnipeg, Manitoba). By linkage to Manitoba Health and Healthy Living's administrative databases, a patient's first gastrointestinal investigation (abdominal radiological imaging, lower gastrointestinal endoscopy or fecal occult blood test) before CRC diagnosis was identified. The index contact with the health care system was estimated from the date of the visit with the physician who ordered the first gastroenterological investigation. The OWT was defined as the time from the index contact to the first treatment, while diagnostic delay was defined as the time from the index contact to the diagnosis of CRC. Multivariate Cox regression analysis was performed to determine independent predictors of OWT.
  
  
  RESULTS
  The OWT was estimated for 2552 cases of CRC over the five years that were examined. The median OWT increased from 61 days in 2001 to 95 days in 2005 (P<0.001). Most of the increase was in diagnostic wait times (median of 44 days in 2001 versus 64 days in 2005 [P<0.001]). Year of diagnosis, older age, urban residence and diagnosis at a teaching facility were independent predictors of OWT.
  
  
  CONCLUSIONS
  The OWT from presentation to treatment of CRC in Manitoba steadily increased between 2001 and 2005, mostly due to diagnostic delays.
authors.affiliation: University of Manitoba, Winnipeg, Canada. singh@cc.umanitoba.ca
authors.forename: H
authors.initials: H
authors.lastname: Singh
authors.forename: C
authors.initials: C
authors.lastname: De Coster
authors.forename: E
authors.initials: E
authors.lastname: Shu
authors.forename: K
authors.initials: K
authors.lastname: Fradette
authors.forename: S
authors.initials: S
authors.lastname: Latosinsky
authors.forename: M
authors.initials: M
authors.lastname: Pitz
authors.forename: M
authors.initials: M
authors.lastname: Cheang
authors.forename: D
authors.initials: D
authors.lastname: Turner
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D005762:Gastroenterology / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D016016:Proportional Hazards Models; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D014505:Urban Population; D014850:Waiting Lists