title: Wait times for prostate cancer treatment and patient perceptions of care in Canada: a mixed-methods report.
abstract: BACKGROUND
  Access to cancer care is a significant concern for Canadians. Prolonged delays between cancer diagnosis and treatment have been associated with anxiety, stress, and perceived powerlessness for patients and their family members. Longer wait times can also be associated with poorer prognosis, although the evidence is inconclusive. Here, we report national wait times for radiation therapy and surgery for localized prostate cancer (pca) and the effect of wait time on patient perceptions of their care.
  
  
  RESULTS
  Treatment wait times showed substantial interprovincial variation. The longest 90th percentile wait times for radiation therapy and surgery were, respectively, 40 days and 105 days. In all provinces, waits for radiation therapy were longer for pca patients than for patients with breast, colorectal, or lung cancer. In the focus groups and interviews conducted with 47 men treated for pca, many participants did not perceive that wait times for treatment were prolonged. Those who experienced delays between diagnosis and treatment voiced issues with a lack of communication about when they would receive treatment and a lack of support or information to make an informed decision about treatment. Minimizing treatment delays was an aspect of the cancer journey that participants would like to change because of the stress it caused.
  
  
  CONCLUSIONS
  Although wait time statistics are useful, a review of cancer control in Canada cannot be considered complete unless an effort is made to give voice to the experiences of individuals with cancer. The findings presented here are intended to provide a snapshot of national care delivery for localized pca and to identify opportunities for improvement in clinical practice.
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON;
authors.forename: K
authors.initials: K
authors.lastname: Tran
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON;
authors.forename: C
authors.initials: C
authors.lastname: Sandoval
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON;
authors.forename: R
authors.initials: R
authors.lastname: Rahal
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON; ; Faculty of Medicine, Dalhousie University, Halifax, NS;
authors.forename: G
authors.initials: G
authors.lastname: Porter
authors.affiliation: Department of Urology, Queen's University, Kingston, ON;
authors.forename: R
authors.initials: R
authors.lastname: Siemens
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON;
authors.forename: J
authors.initials: J
authors.lastname: Hernandez
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON;
authors.forename: S
authors.initials: S
authors.lastname: Fung
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON;
authors.forename: C
authors.initials: C
authors.lastname: Louzado
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON;
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.affiliation: Canadian Partnership Against Cancer, Toronto, ON; ; Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB.
authors.forename: H
authors.initials: H
authors.lastname: Bryant
keywords: Prostate cancer; access to health care; qualitative research; radiation therapy; surgery; treatment