title: Wait times in prostate cancer diagnosis and radiation treatment.
abstract: BACKGROUND
  Wait times for cancer diagnosis and treatment are a significant concern for Canadians. Men with prostate cancer experience longer waiting times for diagnosis and treatment than those observed for other cancers. Longer waits are associated with both patient and family psychosocial distress and may be associated with worse prognosis.
  
  
  METHODS
  Men referred for treatment of prostate cancer at a single Canadian cancer centre were interviewed. The intervals from suspicion to definitive therapy were calculated, factors associated with delays along this pathway were identified, and common causes of delay identified by patients were described.
  
  
  RESULTS
  A total of 41 consecutive patients participated. The median interval from suspicion to the first fraction of radiotherapy for all patients was 247 days (interquartile range [IQR] 168-367 d). The median diagnostic interval was 53 days (IQR 28-166 d). The median treatment interval was 127 days (IQR 100-180 d). Patients under 70 years old and patients with <T2c disease had shorter intervals from suspicion to treatment. From diagnosis to start of radiotherapy, patients with low-risk disease had longer intervals. Seventy percent of patients perceived a delay in their care, of which 45%, 31% and 24% of patients felt the delays were due to the health care system, patient or physician factors, respectively.
  
  
  CONCLUSIONS
  In this study, 12% and 0% of patients met Canadian Strategy for Cancer Control and Canadian Association of Radiation Oncologists wait time recommendations, respectively. A large component of wait time is patient driven. Alternate strategies should be developed and measured to shorten the intervals between the suspicion and treatment of prostate cancer.
authors.affiliation: Fellow, Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, ON;
authors.forename: Christiaan
authors.initials: C
authors.lastname: Stevens
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Bondy
authors.forename: D Andrew
authors.initials: DA
authors.lastname: Loblaw