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Canadian Journal of Gastroenterology
Volume 24, Issue 1, Pages 33-39
Original Article

Wait Times from Presentation to Treatment for Colorectal Cancer: A Population-Based Study

H Singh,1 C De Coster,2 E Shu,3 K Fradette,3 S Latosinksy,2,4 M Pitz,1 M Cheang,2 and D Turner2,3

1Department of Internal Medicine, University of Manitoba, Canada
2Department of Community Health Sciences, University of Manitoba, Canada
3Epidemiology and Cancer Registry, CancerCare Manitoba, Canada
4Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada

Received 12 March 2009; Accepted 13 April 2009

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: The wait time from cancer diagnosis to treatment has been a recent focus of cancer care in Canada.

OBJECTIVE: To examine the trends in wait times from patient presentation to treatment (overall health system wait time [OWT]) for colorectal cancer (CRC).

METHODS: Patients with colorectal adenocarcinomas, diagnosed between 2001 and 2005, and their first definitive treatments were identified from the population-based Manitoba Cancer Registry (Winnipeg, Manitoba). By linkage to Manitoba Health and Healthy Living’s administrative databases, a patient’s first gastrointestinal investigation (abdominal radiological imaging, lower gastrointestinal endoscopy or fecal occult blood test) before CRC diagnosis was identified. The index contact with the health care system was estimated from the date of the visit with the physician who ordered the first gastroenterological investigation. The OWT was defined as the time from the index contact to the first treatment, while diagnostic delay was defined as the time from the index contact to the diagnosis of CRC. Multivariate Cox regression analysis was performed to determine independent predictors of OWT.

RESULTS: The OWT was estimated for 2552 cases of CRC over the five years that were examined. The median OWT increased from 61 days in 2001 to 95 days in 2005 (P<0.001). Most of the increase was in diagnostic wait times (median of 44 days in 2001 versus 64 days in 2005 [P<0.001]). Year of diagnosis, older age, urban residence and diagnosis at a teaching facility were independent predictors of OWT.

CONCLUSIONS: The OWT from presentation to treatment of CRC in Manitoba steadily increased between 2001 and 2005, mostly due to diagnostic delays.