Delay to curative surgery greater than 12 weeks is associated with increased mortality in patients with colorectal and breast cancer but not lung or thyroid cancer

Dong Wook Shin, Juhee Cho, So Young Kim, Eliseo Guallar, Seung Sik Hwang, Belong Cho, Jae Hwan Oh, Ki Wook Jung, Hong Gwan Seo, Jong Hyock Park

Research output: Contribution to journalArticle

Abstract

Background: Surgery for cancer is often delayed due to variety of patient-, provider-, and health system-related factors. However, impact of delayed surgery is not clear, and may vary among cancer types. We aimed to determine the impact of the delay from cancer diagnosis to potentially curative surgery on survival. Methods: Cohort study based on representative sample of patients (n = 7,529) with colorectal, breast, lung and thyroid cancer with local or regional disease who underwent potentially curative surgery as their first therapeutic modality within 1 year of cancer diagnosis. They were diagnosed in 2006 and followed for mortality until April 2011, a median follow-up of 4.7 years. Results: For colorectal and breast cancers, the adjusted hazard ratios (95 % confidence intervals) for all-cause mortality comparing a surgical delay beyond 12 weeks to performing surgery within weeks 1-4 after diagnosis were 2.65 (1.50-4.70) and 1.91 (1.06-3.49), respectively. No clear pattern of increased risk was observed with delays between 4 and 12 weeks, or for any delay in lung and thyroid cancers. Concordance between the area of the patient's residence and the hospital performing surgery, and the patient's income status were associated with delayed surgery. Conclusions: Delays to curative surgery beyond 12 weeks were associated with increased mortality in colorectal and breast cancers, suggesting that health provision services should be organized to avoid unnecessary treatment delays. Health care systems should also aim to reduce socioeconomic and geographic disparities and to guarantee equitable access to high quality cancer care.

Original languageEnglish (US)
Pages (from-to)2468-2476
Number of pages9
JournalAnnals of Surgical Oncology
Volume20
Issue number8
DOIs
StatePublished - Aug 2013

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Thyroid Neoplasms
Colorectal Neoplasms
Lung Neoplasms
Breast Neoplasms
Mortality
Neoplasms
Patient Advocacy
Quality of Health Care
Health Services
Cohort Studies
Confidence Intervals
Delivery of Health Care
Survival
Health
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Delay to curative surgery greater than 12 weeks is associated with increased mortality in patients with colorectal and breast cancer but not lung or thyroid cancer. / Shin, Dong Wook; Cho, Juhee; Kim, So Young; Guallar, Eliseo; Hwang, Seung Sik; Cho, Belong; Oh, Jae Hwan; Jung, Ki Wook; Seo, Hong Gwan; Park, Jong Hyock.

In: Annals of Surgical Oncology, Vol. 20, No. 8, 08.2013, p. 2468-2476.

Research output: Contribution to journalArticle

Shin, Dong Wook ; Cho, Juhee ; Kim, So Young ; Guallar, Eliseo ; Hwang, Seung Sik ; Cho, Belong ; Oh, Jae Hwan ; Jung, Ki Wook ; Seo, Hong Gwan ; Park, Jong Hyock. / Delay to curative surgery greater than 12 weeks is associated with increased mortality in patients with colorectal and breast cancer but not lung or thyroid cancer. In: Annals of Surgical Oncology. 2013 ; Vol. 20, No. 8. pp. 2468-2476.
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