title: Is timing to delivery of treatment a reliable measure of quality of care for patients with colorectal adenocarcinoma?
abstract: BACKGROUND
  Among patients with colorectal adenocarcinoma, patient race has been associated with differences in colorectal cancer survival. Survival disparities between ethnic groups may be related to treatment delays, treating hospital, or other patient factors. We hypothesized that prolonged interval to delivery of cancer therapy negatively impacts survival.
  
  
  METHODS
  We designed a retrospective cohort study using tumor registry and clinical database information from two academically affiliated hospitals. We examined factors associated with interval to treatment and associations between interval and overall survival.
  
  
  RESULTS
  Among 592 patients treated by a cohort of physicians, we found no differences in cancer stage related to race or treating hospital. Interval to treatment differed between different hospitals (29 vs. 16 days; P < .0001); yet, there were no differences in overall survival related to treatment interval, treating hospital, race, or insurance status. Tumor grade and tumor stage were associated with decreased overall survival.
  
  
  CONCLUSIONS
  Differences exist related to the timing of definitive care for patients in this series; however, these differences do not translate directly into differences in overall survival. We must deliver quality health care in an efficient and timely manner; however, the metric of interval to treatment may not measure reliably the quality of care received.
authors: Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center at Dallas, TX 75390-9155, USA.
authors: Christina L
authors: CL
authors: Roland
authors: Roderich E
authors: RE
authors: Schwarz
authors: Liyue
authors: L
authors: Tong
authors: Chul
authors: C
authors: Ahn
authors: Glen C
authors: GC
authors: Balch
authors: Adam C
authors: AC
authors: Yopp
authors: Thomas
authors: T
authors: Anthony
authors: John C
authors: JC
authors: Mansour
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011787:Quality of Health Care; D012189:Retrospective Studies; D013997:Time Factors