title: Pancreatic cancer: Wait times from presentation to treatment and survival in a population-based study.
abstract: Pancreatic survival is one of the worst in oncology. To what extent wait times affect outcomes in unknown No population-based study has previously explored patient and treatment delays among individuals with pancreatic cancer. The aim of this study was to estimate patient and treatment delays in patients with pancreatic cancer and to measure their association with survival in a nonselected population. All patients diagnosed with pancreatic cancer for the first time between 2009 and 2011 and registered in two French digestive cancer registries were included. Patient delay (time from onset of symptoms until the first consultation categorized into <1 or ≥1 month), and treatment delay (time between the first consultation and treatment categorized into less or more than 29 days, the median time) were collected. Overall delay was used to test associations between survival and the timeliness of care by combining patient delay and treatment delay. Patient delay was longer than 1 month in 46% of patients. A patient delay longer than one month was associated with the absence of jaundice (p < 0.001) and the presence of metastasis (p = 0.003). After adjusting for other covariates, such as symptoms and treatment, the presence of metastasis was negatively associated with treatment delay longer than 29 days (p = 0.025). After adjustment for other covariates, especially metastatic dissemination and the result of the resection, overall delay was not significantly associated with prognosis. We found little evidence to suggest that timely care was associated with the survival of patients.
authors.affiliation: CHU Dijon Bourgogne, Registre Bourguignon des Cancers Digestifs, F-21000 Dijon, France; INSERM, LNC UMR866, F-21000 Dijon, France; Université Bourgogne Franche-Comté, LNC UMR866, F-21000 Dijon, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Jooste
authors.affiliation: University Hospital of Caen, U1086 INSERM UCBN "Cancers & Preventions", Caen, F-14, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dejardin
authors.affiliation: University Hospital of Caen, U1086 INSERM UCBN "Cancers & Preventions", Caen, F-14, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Bouvier
authors.affiliation: Breast and Gynaecologic Cancer Registry of Côte D'Or, Centre Georges-François Leclerc Comprehensive Cancer Care Centre, Dijon, F-21, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Arveux
authors.affiliation: Registre Des Hémopathies Malignes De Côte D'Or, EA4184, University of Burgundy, Dijon, F-21, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Maynadie
authors.affiliation: University Hospital of Caen, U1086 INSERM UCBN "Cancers & Preventions", Caen, F-14, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Launoy
authors.affiliation: CHU Dijon Bourgogne, Registre Bourguignon des Cancers Digestifs, F-21000 Dijon, France; INSERM, LNC UMR866, F-21000 Dijon, France; Université Bourgogne Franche-Comté, LNC UMR866, F-21000 Dijon, France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bouvier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D011159:Population Surveillance; D012307:Risk Factors; D015996:Survival Rate; D061665:Time-to-Treatment
keywords: cancer registry; epidemiology; pancreatic cancer; patient delay; survival; treatment delay