title: Time from diagnosis to surgery and prostate cancer survival: a retrospective cohort study.
abstract: BACKGROUND
  A diagnosis of prostate cancer leads to emotional distress and anxiety, prompting calls for rapid diagnostic pathways. Nevertheless, it remains unclear what impact time between diagnosis and surgery has upon prostate cancer survival.
  
  
  METHODS
  Using national databases for England (cancer registries, Hospital Episode Statistics and Office of National Statistics), we identified 17,043 men with prostate cancer, aged 15 years and older, diagnosed in 1996-2009, and who had surgical resection with curative intent within 6 months of diagnosis. We used relative survival to investigate associations between waiting times and five- and ten-year survival.
  
  
  RESULTS
  Five- and ten-year relative survival estimates for the total study sample were 1.04 (95% CI: 1.04 to 1.05) and 1.08 (95% CI: 1.06-1.09), respectively. There were no notable differences in survival between patients who had surgery at 0-3 and 4-6 months after diagnosis. Relative survival was higher among the elderly (>65) and those with well and moderately differentiated tumours.
  
  
  CONCLUSIONS
  The high relative survival in our cohort probably reflects adherence to selection criteria for surgery among men with localised prostate cancer. Among men treated with surgery within 6 months of diagnosis, we found little evidence of an association between time from diagnosis to surgery and survival.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK. theresa.redaniel@bristol.ac.uk.
authors.forename: Maria Theresa
authors.initials: MT
authors.lastname: Redaniel
authors.forename: Richard M
authors.initials: RM
authors.lastname: Martin
authors.forename: David
authors.initials: D
authors.lastname: Gillatt
authors.forename: Julia
authors.initials: J
authors.lastname: Wade
authors.forename: Mona
authors.initials: M
authors.lastname: Jeffreys
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004739:England; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000601:surgery; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult