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The wait time to primary surgery in endometrial cancer - impact on survival and predictive factors: a population-based SweGCG study
Hallands Hosp Varberg, Dept Obstet & Gynaecol, Varberg, Sweden.;Reg Canc Ctr Western Sweden, Gothenburg, Sweden..ORCID iD: 0000-0001-7512-185X
Linköping Univ, Dept Oncol, Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden..
Reg Canc Ctr Western Sweden, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Oncol, Gothenburg, Sweden..ORCID iD: 0000-0001-5107-4550
Lund Univ, Skane Univ Hosp, Dept Obstet & Gynaecol, Lund, Sweden.;Lund Univ, Dept Clin Sci, Lund, Sweden..
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2022 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 61, no 1, p. 30-37Article in journal (Refereed) Published
Abstract [en]

Background 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. Material and methods 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). Results 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. Conclusions 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.

Place, publisher, year, edition, pages
Informa UK Limited Taylor & Francis, 2022. Vol. 61, no 1, p. 30-37
Keywords [en]
Endometrial cancer, wait time, time to surgery, time to treatment, delay
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-470075DOI: 10.1080/0284186X.2021.1992006ISI: 000714791600001PubMedID: 34736369OAI: oai:DiVA.org:uu-470075DiVA, id: diva2:1648356
Funder
Swedish Cancer SocietyAvailable from: 2022-03-30 Created: 2022-03-30 Last updated: 2024-12-03Bibliographically approved

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Stålberg, Karin

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