58.
CANCER PATIENT PATHWAYS SHORTENS WAITING TIMES
AND ACCELERATES THE DIAGNOSTIC PROCESS OF SUSPECTED
SARCOMA PATIENTS IN DENMARK
Heidi Buvarp Dyrop, Peter Vedsted, Katja Maretty-Nielsen, Bjarne Hauge
Hansen, Peter Holmberg Jørgensen, Johnny Keller
Department of Experimental Clinical Oncology Aarhus University Hospital;
The Research Unit for General Practice, Aarhus University; Department of
Experimental Clinical Oncology, Aarhus University Hospital; Department of
Orthopaedics, Sarcoma Centre of Aarhus University Hospital; Department of
Orthopaedics, Sarcoma Centre of Aarhus University Hospital; Department of
Orthopaedics, Sarcoma Centre of Aarhus University Hospital
Background:
Waiting times delaying the diagnosis of cancer can cause
frustration and anxiety among patients and may also affect the prognosis. In
Denmark, Cancer Patient Pathways (CPPs) have been implemented to address
this problem.
Purpose / Aim of Study:
To investigate the development in time intervals and
tumour size at diagnosis after implementation of CPPs, and describe reasons
for waiting time among sarcoma patients.
Materials and Methods:
An observational population-based study with
before-after comparison. Medical files of patients (n=1126) referred with
suspected sarcoma from other hospitals to the Aarhus Sarcoma Centre two
years before (2007-08) and two years after (2009-10) the implementation were
reviewed for data on processing times, performed diagnostics, symptom
duration and tumour size at diagnosis. Intervals were measured as medians
with interquartile intervals and tested for trend over the years.
Findings / Results:
There was a trend of reduced median time intervals in all
diagnostic phases in the centre. Reduction in the phase “referral to first
appointment” was significant for all patients. For bone sarcomas we found
significant reduction in median from 11 to 5 work days in the phase “first
appointment to decision of treatment”, and for soft tissue sarcomas a
significantly reduced median from 28 to 18 work days in the phase “referral to
start of treatment”. At referral, median tumour size of soft tissue sarcomas was
significantly reduced from 7 to 5 cm., but symptom duration was unchanged.
Delays were caused mostly by supplementary diagnostics, and passive waiting
time was rare.
Conclusions:
CPPs have been successful in accelerating the diagnostic process
of suspected sarcoma patients, and the reduced tumour size may indicate an
earlier diagnosis. However, more efforts are needed in the area of public
awareness to reduce patient interval.
