title: Longer waiting times for patients undergoing colorectal cancer surgery are not associated with decreased survival.
abstract: OBJECTIVE
  Wait times are a growing concern in Canada's publicly-funded healthcare system. We sought to determine if increased wait times for colorectal cancer (CRC) treatments resulted in worse outcomes.
  
  
  METHODS
  A population-based retrospective cohort analysis of wait times for CRC patients undergoing major surgical resections in Manitoba, Canada, between 2004 and 2006 was undertaken. Administrative records were utilized to estimate total wait time (TWT), defined as the sum of time from index contact with the healthcare system to diagnosis of CRC (diagnostic wait time [DWT]) and the time from diagnosis to first cancer treatment (treatment wait time [TxWT]). Multivariate Cox regression analysis of 5-year overall survival was performed to determine the effect of TWT quartiles on survival.
  
  
  RESULTS
  One thousand six hundred twenty eight patients with stage I-IV CRC underwent major surgery with a median TWT of 95 days. Predictors of lower 5-year survival included advanced age, higher stage, lower economic status, increased medical comorbidity, urgent presentation, living between 101 and 500 km from the Provincial cancer center, and not receiving adjuvant chemotherapy. After controlling for these variables, TWT quartiles were not associated with survival (P = 0.4898).
  
  
  CONCLUSIONS
  On a population basis, increased TWT was not associated with worse survival, while controlling for important confounders.
authors.affiliation: The University of Manitoba, Department of Surgery, Winnipeg, Manitoba.
authors.forename: Ramzi M
authors.initials: RM
authors.lastname: Helewa
authors.forename: Donna
authors.initials: D
authors.lastname: Turner
authors.forename: Jason
authors.initials: J
authors.lastname: Park
authors.forename: Debrah
authors.initials: D
authors.lastname: Wirtzfeld
authors.forename: Piotr
authors.initials: P
authors.lastname: Czaykowski
authors.forename: David
authors.initials: D
authors.lastname: Hochman
authors.forename: Harminder
authors.initials: H
authors.lastname: Singh
authors.forename: Emma
authors.initials: E
authors.lastname: Shu
authors.forename: Andrew
authors.initials: A
authors.lastname: McKay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: colorectal cancer; survival; wait times