title: Family physician access to and wait times for cancer diagnostic investigations: Regional differences among 3 provinces.
abstract: OBJECTIVE
  To examine provincial and regional differences in FPs' direct access to cancer diagnostic investigations and advice from other specialists regarding investigations and referrals, and to explore FPs' perceptions about wait times for diagnostic investigations and receipt of results.
  
  
  METHODS
  A cross-sectional, online survey.
  
  
  METHODS
  British Columbia, Manitoba, and Ontario.
  
  
  METHODS
  A sample of FPs from participating provinces.
  
  
  METHODS
  Direct FP access to various diagnostic investigations and advice from other specialists regarding investigations and referrals; FPs' perceptions about wait times for diagnostic investigations ordered directly; and FPs' perceptions about wait times for results.
  
  
  RESULTS
  A total of 1054 surveys were completed by FPs from British Columbia (n = 229), Manitoba (n = 228), and Ontario (n = 597). Distance from a cancer centre was not significantly associated with direct access to or wait times for diagnostic investigations for most of the investigations studied; however, provincial differences were observed. Family physicians in Manitoba and British Columbia were 30% to 45% less likely to report having direct access to endoscopy and some imaging investigations compared with FPs in Ontario. Family physicians in Manitoba and British Columbia were also at increased odds of waiting longer than 12 weeks for endoscopy investigations and longer than 4 weeks for imaging investigations compared with FPs in Ontario. Most FPs reported wait times of less than 2 weeks for imaging results; however, the proportion of FPs who waited longer than 2 weeks for colonoscopy results ranged from 15% in Ontario to 96% in British Columbia.
  
  
  CONCLUSIONS
  Given the disparities observed among provinces, there is an opportunity for provinces to learn from one another to improve direct access to and shorten wait times for diagnostic investigations. This in turn has the potential to shorten the primary care interval for cancer diagnostic assessment.
authors.affiliation: Senior Research Associate for the Ontario Renal Network of Cancer Care Ontario in Toronto, Ont, and was with the Department of Prevention and Cancer Control at the time of manuscript development. andriana.barisic@renalnetwork.on.ca.
authors.forename: Andriana
authors.initials: A
authors.lastname: Barisic
authors.affiliation: Research Associate at Cancer Care Ontario and was a master's student in the Department of Pharmacology and Toxicology at the University of Toronto.
authors.forename: Maxine
authors.initials: M
authors.lastname: Kish
authors.affiliation: Staff scientist and Manager of Research and Evaluation at Cancer Care Ontario and Adjunct Professor in the Institute for Health Policy, Management and Evaluation at the University of Toronto.
authors.forename: Julie
authors.initials: J
authors.lastname: Gilbert
authors.affiliation: Chief Research Officer at Cancer Care Ontario.
authors.forename: Nicole
authors.initials: N
authors.lastname: Mittmann
authors.affiliation: Professor and a senior biostatistician in the Department of Family and Community Medicine at the University of Toronto.
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.affiliation: Chair of the College of Family Physicians of Canada's Cancer Care Program of the Section of Communities of Practice in Family Medicine and Vice-Dean of the Office of Continuing Competency and Assessment in the Faculty of Health Sciences and Professor in the Department of Family Medicine at the University of Manitoba in Winnipeg.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Sisler
authors.affiliation: Professor in the Research Unit for General Practice in the Department of Public Health at Aarhus University in Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.affiliation: Giblon Professor and Vice-Chair of Research in the Department of Family and Community Medicine at the University of Toronto and Director of Knowledge Translation Research in the Health Services Research Program at the Ontario Institute for Cancer Research.
authors.forename: Eva
authors.initials: E
authors.lastname: Grunfeld
mesh_terms: D001955:British Columbia / Q000453:epidemiology; D003113:Colonoscopy / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007391:International Cooperation; D016015:Logistic Models; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D010821:Physicians, Family / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014850:Waiting Lists