title: Cancer Patient Pathways shortens waiting times and accelerates the diagnostic process of suspected sarcoma patients in Denmark.
abstract: Cancer Patient Pathways (CPPs) for suspected cancer were implemented in Denmark to reduce waiting times for cancer diagnosis and treatment. Our study describes developments in time intervals and tumour size in a natural experiment before and after implementation of the CPP for sarcomas (January 1st, 2009). Medical files for patients referred with suspected sarcoma from other hospitals to Aarhus Sarcoma Centre during 2007-2010 (n=1126) were reviewed for data on milestones, time intervals, performed diagnostics, and tumour size. Results showed a statistically significant reduction in median number of work days in the phase "referral to first appointment" for all patients. For bone sarcomas, median time was significantly reduced from 11 to five work days in the phase "first appointment to decision of treatment", for soft tissue sarcomas it was reduced from 28 to 18 work days in the phase "referral to start of treatment". Passive waiting time was reduced, and delays in the fast-track programme were caused mostly by supplementary diagnostics. Median tumour size for soft tissue sarcomas was reduced from 7.0 to 4.9cm, possibly a secondary effect of increased awareness. CPPs have accelerated the diagnostic process for sarcomas, and our results may aid international development of similar initiatives.
authors.affiliation: Department of Experimental Clinical Oncology, Aarhus University Hospital, Norrebrogade 44, Bldg. 5, DK-8000 Aarhus C, Denmark; Sarcoma Centre of Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus C, Denmark. Electronic address: heidi@oncology.dk.
authors.forename: Heidi Buvarp
authors.initials: HB
authors.lastname: Dyrop
authors.forename: Akmal
authors.initials: A
authors.lastname: Safwat
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.forename: Katja
authors.initials: K
authors.lastname: Maretty-Nielsen
authors.forename: Bjarne Hauge
authors.initials: BH
authors.lastname: Hansen
authors.forename: Peter Holmberg
authors.initials: PH
authors.lastname: Jørgensen
authors.forename: Thomas
authors.initials: T
authors.lastname: Baad-Hansen
authors.forename: Cody
authors.initials: C
authors.lastname: Bünger
authors.forename: Johnny
authors.initials: J
authors.lastname: Keller
mesh_terms: D000328:Adult; D000368:Aged; D019091:Critical Pathways; D003718:Denmark; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012509:Sarcoma / Q000473:pathology* / Q000628:therapy*; D013997:Time Factors; D014850:Waiting Lists
keywords: Cancer Patient Pathway; Denmark; Early cancer diagnosis; Neoplasm; Sarcoma