Premium
Audit of the association between length of time spent on diagnostic work‐up and tumour stage in patients with symptomatic colon cancer
Author(s) -
Tiong Jimmy,
Gray Andrew,
Jackson Christopher,
ThompsonFawcett Mark,
Schultz Michael
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12804
Subject(s) - medicine , stage (stratigraphy) , colonoscopy , colorectal cancer , demographics , audit , work up , retrospective cohort study , cancer , emergency medicine , surgery , demography , biology , paleontology , management , sociology , economics
Background Colorectal cancer is one of the most incident cancers in N ew Z ealand. Due to resource limitations, some patients experienced protracted wait times before reaching a definitive diagnosis. We analysed the relationship between time to diagnosis and clinical stage and reviewed the length of time for components of the diagnostic work‐up to identify priority areas for service improvement. We benchmarked our timeliness against introduced standards. Methods This retrospective study included all patients with colonic (not rectal) cancer between O ctober 2007 and S eptember 2009. Patients were stratified into an early and advanced group. Types of delay were calculated from the onset of symptoms to the administration of treatment. The compliance with target waiting times was assessed. Results Fifty‐eight patients were included in the early group and 83 patients in the advanced group. There were no significant differences in demographics or symptoms. The work‐up was longer than international benchmarks, but with wide variations. There was no statistical difference between lengths of work‐up in the groups. The advanced group had increased utilization of private and emergency investigations. Forty‐four per cent met the diagnostic colonoscopy target waiting time of 42 days with a trend in favour of the advanced group and 21% received treatment within 62 days (non‐significant). Conclusion Current systems are not sophisticated enough to predict the stage of colon cancer. Here, long waiting times were not associated with cancer stage in symptomatic patients. Resources need to be directed to diagnostic colonic imaging.