[Introduction of integrated cancer pathway shortens diagnostic delay in bladder cancer].
BACKGROUND
The aim of the present paper is, firstly, to investigate the distribution of diagnostic delay between the primary sector, the primary urological departments and the highly specialized department for patients with cancer of the urinary bladder. Secondly, the paper aims to investigate how the introduction of a waiting time guarantee and integrated cancer treatment pathways have affected diagnostic delay.


METHODS
The study comprised case journals from patients who were cystectomized at the Department of Urology D, Rigshospitalet. A total of 151 journals from 2001 and 2005-2006 as well as 2009 were reviewed. The investigation time was studied with a view to three time periods: from symptom onset to first hospital contact (phase 1), from examination at the first hospital department to referral (phase 2), from referral was received at the specialized department to cystectomy (phase 3). The total diagnostic delay was also studied.


RESULTS
This study has revealed a reduction in the duration of phases 1 and 2 from 2001 to 2009. In phase 2, in particular, we have observed a significant reduction from 2001 to 2009 (p < 0.01).


CONCLUSIONS
The introduction of integrated cancer pathways has reduced the diagnostic delay for cancer of the urinary bladder by approximately one month from 243 days to 203 days.
Urologisk Klinik D, Abdominalcentret, Rigshospitalet, Denmark. marike_l@me.com
Marike
M
Lijkendijk
Peter
P
Thind
D000328:Adult; D000368:Aged; D019091:Critical Pathways; D015653:Cystectomy; D057210:Delayed Diagnosis; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014850:Waiting Lists