title: Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002.
abstract: OBJECTIVE
  Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the potential influence of fast track by comparing waiting times in 2010 to 2002 and 1992.
  
  
  METHODS
  Charts of all new patients diagnosed with squamous cell carcinoma of the oral cavity, pharynx and larynx at the five Danish head and neck oncology centres from January to April 2010 (n=253) were reviewed and compared to similar data from 2002 (n=211) and 1992 (n=168).
  
  
  RESULTS
  The median time to diagnosis was 13 days (2010) versus 17 days (2002; p<0.001) and 20 days (1992; p<0.001). Median days from diagnosis to treatment start were 25 (2010) versus 47 (2002; p<0.001) and 31 (1992; p<0.001). Total pre-treatment time was median 41 days in 2010 versus 69 days (2002) (p<0.001) and 50 days (1992; p<0.001). Significantly more diagnostic imaging was done in 2010 compared to 2002 and 1992. When compared to current fast track standards the adherence to diagnosis improved slightly from 47% (1992) to 51% (2002) and 64% (2010); waiting time for radiotherapy was within standards for 7%, 1% and 22% of cases, respectively; waiting time for surgery was within standards for 17%, 22% and 48%, respectively.
  
  
  CONCLUSIONS
  The study showed a significant reduction in delay of diagnosis and treatment of head and neck cancer in 2010, but still less than half of all patients start treatment within the current standards.
authors.affiliation: Department of Oncology, Aarhus University Hospital, Denmark. ninamunklyhne@gmail.com
authors.forename: N M
authors.initials: NM
authors.lastname: Lyhne
authors.forename: A
authors.initials: A
authors.lastname: Christensen
authors.forename: M C
authors.initials: MC
authors.lastname: Alanin
authors.forename: M T
authors.initials: MT
authors.lastname: Bruun
authors.forename: T H
authors.initials: TH
authors.lastname: Jung
authors.forename: M A
authors.initials: MA
authors.lastname: Bruhn
authors.forename: J B B
authors.initials: JB
authors.lastname: Jespersen
authors.forename: C A
authors.initials: CA
authors.lastname: Kristensen
authors.forename: E
authors.initials: E
authors.lastname: Andersen
authors.forename: C
authors.initials: C
authors.lastname: Godballe
authors.forename: C
authors.initials: C
authors.lastname: Buchwald
authors.forename: T
authors.initials: T
authors.lastname: Bundgaard
authors.forename: J
authors.initials: J
authors.lastname: Johansen
authors.forename: K
authors.initials: K
authors.lastname: Lambertsen
authors.forename: H
authors.initials: H
authors.lastname: Primdahl
authors.forename: K
authors.initials: K
authors.lastname: Toustrup
authors.forename: J A
authors.initials: JA
authors.lastname: Sørensen
authors.forename: J
authors.initials: J
authors.lastname: Overgaard
authors.forename: C
authors.initials: C
authors.lastname: Grau
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy*; D003718:Denmark; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000592:standards / Q000639:trends; D010548:Personal Health Services / Q000592:standards / Q000639:trends; D013997:Time Factors; D014850:Waiting Lists