The wait time to primary surgery in endometrial cancer - impact on survival and predictive factors: a population-based SweGCG study
Poor survival rates in different cancer types are sometimes blamed on diagnostic and treatment delays, and it has been suggested that such delays might be related to sociodemographic factors such as education and ethnicity. We examined associations of the wait time from diagnosis to surgery and surv...
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| Veröffentlicht in: | Acta oncologica 2022, Vol.61 (1), p.30-37 |
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| creator | Marcickiewicz, Janusz Åvall-Lundqvist, Elisabeth Holmberg, Erik Carl Viktor Borgfeldt, Christer Bjurberg, Maria Dahm-Kähler, Pernilla Flöter-Rådestad, Angelique Hellman, Kristina Högberg, Thomas Rosenberg, Per Stålberg, Karin Kjølhede, Preben |
| description | Poor survival rates in different cancer types are sometimes blamed on diagnostic and treatment delays, and it has been suggested that such delays might be related to sociodemographic factors such as education and ethnicity. We examined associations of the wait time from diagnosis to surgery and survival in endometrial cancer (EC) and explored patient and tumour factors influencing the wait time.
In this historical population-based cohort study, The Swedish Quality Registry for Gynaecologic Cancer (SQRGC) was used to identify EC patients who underwent primary surgery between 2010 and 2018. Factors associated with a wait time > 32 d were analysed with logistic regression. The 32-d time point was defined in accordance with the Swedish Standardisation Cancer Care programme. Adjusted Poisson regression analyses were used to analyse excess mortality rate ratio (EMRR).
Out of 7366 women, 5535 waited > 32 d for surgery and 1098 > 70 d. The overall median wait time was 44 d. The factors most strongly associated with a wait time > 32 d were surgery at a university hospital (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.08-1.66) followed by country of birth (OR 1.31, 95% CI 1.10-1.55) and year of diagnosis. There were no associations between wait time and histology or age. A wait time < 15 d was associated with higher mortality (adjusted EMRR 2.29,95% CI 1.36-3.84) whereas no negative survival impact was seen with a wait time of 70 d. Age, tumour stage, histology and risk group were highly associated with survival, whereas education, country of origin and hospital level did not have any impact on survival.
Surgery within the first two weeks after EC diagnosis was associated with worsened survival. A prolonged wait time did not seem to have any significant adverse effect on prognosis.
Highlights
Surgery within the first two weeks after diagnosis of endometrial cancer (EC) was associated with poorer survival.
A prolonged wait time to surgery did not worsen prognosis.
Delay in time to surgery was associated with sociodemographic factors. |
| doi_str_mv | 10.1080/0284186X.2021.1992006 |
| format | Article |
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In this historical population-based cohort study, The Swedish Quality Registry for Gynaecologic Cancer (SQRGC) was used to identify EC patients who underwent primary surgery between 2010 and 2018. Factors associated with a wait time > 32 d were analysed with logistic regression. The 32-d time point was defined in accordance with the Swedish Standardisation Cancer Care programme. Adjusted Poisson regression analyses were used to analyse excess mortality rate ratio (EMRR).
Out of 7366 women, 5535 waited > 32 d for surgery and 1098 > 70 d. The overall median wait time was 44 d. The factors most strongly associated with a wait time > 32 d were surgery at a university hospital (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.08-1.66) followed by country of birth (OR 1.31, 95% CI 1.10-1.55) and year of diagnosis. There were no associations between wait time and histology or age. A wait time < 15 d was associated with higher mortality (adjusted EMRR 2.29,95% CI 1.36-3.84) whereas no negative survival impact was seen with a wait time of 70 d. Age, tumour stage, histology and risk group were highly associated with survival, whereas education, country of origin and hospital level did not have any impact on survival.
Surgery within the first two weeks after EC diagnosis was associated with worsened survival. A prolonged wait time did not seem to have any significant adverse effect on prognosis.
Highlights
Surgery within the first two weeks after diagnosis of endometrial cancer (EC) was associated with poorer survival.
A prolonged wait time to surgery did not worsen prognosis.
Delay in time to surgery was associated with sociodemographic factors.</description><identifier>ISSN: 0284-186X</identifier><identifier>ISSN: 1651-226X</identifier><identifier>EISSN: 1651-226X</identifier><identifier>DOI: 10.1080/0284186X.2021.1992006</identifier><identifier>PMID: 34736369</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Cancer and Oncology ; Cancer och onkologi ; Clinical Medicine ; Cohort Studies ; delay ; diagnostic delay ; Endometrial cancer ; Endometrial Neoplasms - surgery ; Female ; Gynaecology, Obstetrics and Reproductive Medicine ; Gynekologi, obstetrik och reproduktionsmedicin ; Humans ; Klinisk medicin ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Oncology ; outcomes ; quality ; register ; Sociodemographic Factors ; time to surgery ; Time-to-Treatment ; wait time ; Waiting Lists ; women</subject><ispartof>Acta oncologica, 2022, Vol.61 (1), p.30-37</ispartof><rights>2021 Acta Oncologica Foundation 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c581t-bcfdaba38258dc00972090376dd5be34e385a8e80bff9a08162bf3cf4e5925643</cites><orcidid>0000-0001-5107-4550 ; 0000-0001-7512-185X ; 0000-0001-5702-4116</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/0284186X.2021.1992006$$EPDF$$P50$$Ginformaworld$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/0284186X.2021.1992006$$EHTML$$P50$$Ginformaworld$$H</linktohtml><link.rule.ids>230,314,550,776,780,881,4010,27900,27901,27902,59620,60409</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34736369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-181042$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-470075$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/309844$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/6f4eaca1-d8b5-44b3-8087-1c26670f013d$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:148015640$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Marcickiewicz, Janusz</creatorcontrib><creatorcontrib>Åvall-Lundqvist, Elisabeth</creatorcontrib><creatorcontrib>Holmberg, Erik Carl Viktor</creatorcontrib><creatorcontrib>Borgfeldt, Christer</creatorcontrib><creatorcontrib>Bjurberg, Maria</creatorcontrib><creatorcontrib>Dahm-Kähler, Pernilla</creatorcontrib><creatorcontrib>Flöter-Rådestad, Angelique</creatorcontrib><creatorcontrib>Hellman, Kristina</creatorcontrib><creatorcontrib>Högberg, Thomas</creatorcontrib><creatorcontrib>Rosenberg, Per</creatorcontrib><creatorcontrib>Stålberg, Karin</creatorcontrib><creatorcontrib>Kjølhede, Preben</creatorcontrib><title>The wait time to primary surgery in endometrial cancer - impact on survival and predictive factors: a population-based SweGCG study</title><title>Acta oncologica</title><addtitle>Acta Oncol</addtitle><description>Poor survival rates in different cancer types are sometimes blamed on diagnostic and treatment delays, and it has been suggested that such delays might be related to sociodemographic factors such as education and ethnicity. We examined associations of the wait time from diagnosis to surgery and survival in endometrial cancer (EC) and explored patient and tumour factors influencing the wait time.
In this historical population-based cohort study, The Swedish Quality Registry for Gynaecologic Cancer (SQRGC) was used to identify EC patients who underwent primary surgery between 2010 and 2018. Factors associated with a wait time > 32 d were analysed with logistic regression. The 32-d time point was defined in accordance with the Swedish Standardisation Cancer Care programme. Adjusted Poisson regression analyses were used to analyse excess mortality rate ratio (EMRR).
Out of 7366 women, 5535 waited > 32 d for surgery and 1098 > 70 d. The overall median wait time was 44 d. The factors most strongly associated with a wait time > 32 d were surgery at a university hospital (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.08-1.66) followed by country of birth (OR 1.31, 95% CI 1.10-1.55) and year of diagnosis. There were no associations between wait time and histology or age. A wait time < 15 d was associated with higher mortality (adjusted EMRR 2.29,95% CI 1.36-3.84) whereas no negative survival impact was seen with a wait time of 70 d. Age, tumour stage, histology and risk group were highly associated with survival, whereas education, country of origin and hospital level did not have any impact on survival.
Surgery within the first two weeks after EC diagnosis was associated with worsened survival. A prolonged wait time did not seem to have any significant adverse effect on prognosis.
Highlights
Surgery within the first two weeks after diagnosis of endometrial cancer (EC) was associated with poorer survival.
A prolonged wait time to surgery did not worsen prognosis.
Delay in time to surgery was associated with sociodemographic factors.</description><subject>Cancer and Oncology</subject><subject>Cancer och onkologi</subject><subject>Clinical Medicine</subject><subject>Cohort Studies</subject><subject>delay</subject><subject>diagnostic delay</subject><subject>Endometrial cancer</subject><subject>Endometrial Neoplasms - surgery</subject><subject>Female</subject><subject>Gynaecology, Obstetrics and Reproductive Medicine</subject><subject>Gynekologi, obstetrik och reproduktionsmedicin</subject><subject>Humans</subject><subject>Klinisk medicin</subject><subject>Medical and Health Sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Oncology</subject><subject>outcomes</subject><subject>quality</subject><subject>register</subject><subject>Sociodemographic Factors</subject><subject>time to surgery</subject><subject>Time-to-Treatment</subject><subject>wait time</subject><subject>Waiting Lists</subject><subject>women</subject><issn>0284-186X</issn><issn>1651-226X</issn><issn>1651-226X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNp9ks2O0zAUhSMEYjoDjwDyA5By_RuHFaPCFKRKLBjQ7CwndoohiSM7adU1L45DO91NF9a17v3OubZ0suwNhiUGCe-BSIaleFgSIHiJy5IAiGfZAguOc0LEw_NsMTP5DF1l1zH-BgBCC_4yu6KsoIKKcpH9vf9l0V67EY2us2j0aAiu0-GA4hS2NlXXI9sb39kxON2iWve1DShHrht0PSLfz-TO7dJM9ybJrXH16HYWNWnuQ_yANBr8MLV6dL7PKx2tQd_3dr1aozhO5vAqe9HoNtrXp3qT_bj7fL_6km--rb-ubjd5zSUe86pujK40lYRLUwOUBYESaCGM4ZWlzFLJtbQSqqYpNUgsSNXQumGWl4QLRm-y_Ogb93aYKnX6qfLaqVPrT7pZxXghmUj85km-nYZ0qnRmgUhLdK2xMrLiirGKKgmyULgmQhTQAKbm4vptskut7X83CqVk83PfPcl_cj9vlQ9bNU2KFQAFv2h_xls3KSwxMJJ4fuTr4GMMtjkrMKg5YuoxYmqOmDpFLOneHnVpSWfNWfWYqQR8PAKub3zo9N6H1qhRH1ofmpDi46Kil3f8A3Wz49M</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Marcickiewicz, Janusz</creator><creator>Åvall-Lundqvist, Elisabeth</creator><creator>Holmberg, Erik Carl Viktor</creator><creator>Borgfeldt, Christer</creator><creator>Bjurberg, Maria</creator><creator>Dahm-Kähler, Pernilla</creator><creator>Flöter-Rådestad, Angelique</creator><creator>Hellman, Kristina</creator><creator>Högberg, Thomas</creator><creator>Rosenberg, Per</creator><creator>Stålberg, Karin</creator><creator>Kjølhede, Preben</creator><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ABXSW</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>DG8</scope><scope>ZZAVC</scope><scope>DF2</scope><scope>F1U</scope><scope>D95</scope><orcidid>https://orcid.org/0000-0001-5107-4550</orcidid><orcidid>https://orcid.org/0000-0001-7512-185X</orcidid><orcidid>https://orcid.org/0000-0001-5702-4116</orcidid></search><sort><creationdate>2022</creationdate><title>The wait time to primary surgery in endometrial cancer - impact on survival and predictive factors: a population-based SweGCG study</title><author>Marcickiewicz, Janusz ; Åvall-Lundqvist, Elisabeth ; Holmberg, Erik Carl Viktor ; Borgfeldt, Christer ; Bjurberg, Maria ; Dahm-Kähler, Pernilla ; Flöter-Rådestad, Angelique ; Hellman, Kristina ; Högberg, Thomas ; Rosenberg, Per ; Stålberg, Karin ; Kjølhede, Preben</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c581t-bcfdaba38258dc00972090376dd5be34e385a8e80bff9a08162bf3cf4e5925643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cancer and Oncology</topic><topic>Cancer och onkologi</topic><topic>Clinical Medicine</topic><topic>Cohort Studies</topic><topic>delay</topic><topic>diagnostic delay</topic><topic>Endometrial cancer</topic><topic>Endometrial Neoplasms - surgery</topic><topic>Female</topic><topic>Gynaecology, Obstetrics and Reproductive Medicine</topic><topic>Gynekologi, obstetrik och reproduktionsmedicin</topic><topic>Humans</topic><topic>Klinisk medicin</topic><topic>Medical and Health Sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Oncology</topic><topic>outcomes</topic><topic>quality</topic><topic>register</topic><topic>Sociodemographic Factors</topic><topic>time to surgery</topic><topic>Time-to-Treatment</topic><topic>wait time</topic><topic>Waiting Lists</topic><topic>women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marcickiewicz, Janusz</creatorcontrib><creatorcontrib>Åvall-Lundqvist, Elisabeth</creatorcontrib><creatorcontrib>Holmberg, Erik Carl Viktor</creatorcontrib><creatorcontrib>Borgfeldt, Christer</creatorcontrib><creatorcontrib>Bjurberg, Maria</creatorcontrib><creatorcontrib>Dahm-Kähler, Pernilla</creatorcontrib><creatorcontrib>Flöter-Rådestad, Angelique</creatorcontrib><creatorcontrib>Hellman, Kristina</creatorcontrib><creatorcontrib>Högberg, Thomas</creatorcontrib><creatorcontrib>Rosenberg, Per</creatorcontrib><creatorcontrib>Stålberg, Karin</creatorcontrib><creatorcontrib>Kjølhede, Preben</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>SWEPUB Linköpings universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Linköpings universitet</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Uppsala universitet</collection><collection>SWEPUB Göteborgs universitet</collection><collection>SWEPUB Lunds universitet</collection><jtitle>Acta oncologica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marcickiewicz, Janusz</au><au>Åvall-Lundqvist, Elisabeth</au><au>Holmberg, Erik Carl Viktor</au><au>Borgfeldt, Christer</au><au>Bjurberg, Maria</au><au>Dahm-Kähler, Pernilla</au><au>Flöter-Rådestad, Angelique</au><au>Hellman, Kristina</au><au>Högberg, Thomas</au><au>Rosenberg, Per</au><au>Stålberg, Karin</au><au>Kjølhede, Preben</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The wait time to primary surgery in endometrial cancer - impact on survival and predictive factors: a population-based SweGCG study</atitle><jtitle>Acta oncologica</jtitle><addtitle>Acta Oncol</addtitle><date>2022</date><risdate>2022</risdate><volume>61</volume><issue>1</issue><spage>30</spage><epage>37</epage><pages>30-37</pages><issn>0284-186X</issn><issn>1651-226X</issn><eissn>1651-226X</eissn><abstract>Poor survival rates in different cancer types are sometimes blamed on diagnostic and treatment delays, and it has been suggested that such delays might be related to sociodemographic factors such as education and ethnicity. We examined associations of the wait time from diagnosis to surgery and survival in endometrial cancer (EC) and explored patient and tumour factors influencing the wait time.
In this historical population-based cohort study, The Swedish Quality Registry for Gynaecologic Cancer (SQRGC) was used to identify EC patients who underwent primary surgery between 2010 and 2018. Factors associated with a wait time > 32 d were analysed with logistic regression. The 32-d time point was defined in accordance with the Swedish Standardisation Cancer Care programme. Adjusted Poisson regression analyses were used to analyse excess mortality rate ratio (EMRR).
Out of 7366 women, 5535 waited > 32 d for surgery and 1098 > 70 d. The overall median wait time was 44 d. The factors most strongly associated with a wait time > 32 d were surgery at a university hospital (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.08-1.66) followed by country of birth (OR 1.31, 95% CI 1.10-1.55) and year of diagnosis. There were no associations between wait time and histology or age. A wait time < 15 d was associated with higher mortality (adjusted EMRR 2.29,95% CI 1.36-3.84) whereas no negative survival impact was seen with a wait time of 70 d. Age, tumour stage, histology and risk group were highly associated with survival, whereas education, country of origin and hospital level did not have any impact on survival.
Surgery within the first two weeks after EC diagnosis was associated with worsened survival. A prolonged wait time did not seem to have any significant adverse effect on prognosis.
Highlights
Surgery within the first two weeks after diagnosis of endometrial cancer (EC) was associated with poorer survival.
A prolonged wait time to surgery did not worsen prognosis.
Delay in time to surgery was associated with sociodemographic factors.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>34736369</pmid><doi>10.1080/0284186X.2021.1992006</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5107-4550</orcidid><orcidid>https://orcid.org/0000-0001-7512-185X</orcidid><orcidid>https://orcid.org/0000-0001-5702-4116</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0284-186X |
| ispartof | Acta oncologica, 2022, Vol.61 (1), p.30-37 |
| issn | 0284-186X 1651-226X 1651-226X |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Taylor & Francis Journals Complete; Alma/SFX Local Collection; SWEPUB Freely available online |
| subjects | Cancer and Oncology Cancer och onkologi Clinical Medicine Cohort Studies delay diagnostic delay Endometrial cancer Endometrial Neoplasms - surgery Female Gynaecology, Obstetrics and Reproductive Medicine Gynekologi, obstetrik och reproduktionsmedicin Humans Klinisk medicin Medical and Health Sciences Medicin och hälsovetenskap Oncology outcomes quality register Sociodemographic Factors time to surgery Time-to-Treatment wait time Waiting Lists women |
| title | The wait time to primary surgery in endometrial cancer - impact on survival and predictive factors: a population-based SweGCG study |
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