Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

The wait time to primary surgery in endometrial cancer–impact on survival and predictive factors : a population-based SweGCG study

Marcickiewicz, Janusz ; Åvall-Lundqvist, Elisabeth ; Holmberg, Erik Carl Viktor ; Borgfeldt, Christer LU ; Bjurberg, Maria LU ; Dahm-Kähler, Pernilla ; Flöter-Rådestad, Angelique ; Hellman, Kristina ; Högberg, Thomas LU and Rosenberg, Per , et al. (2022) In Acta Oncologica 61(1). p.30-37
Abstract

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... (More)

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.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.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
delay, Endometrial cancer, time to surgery, time to treatment, wait time
in
Acta Oncologica
volume
61
issue
1
pages
30 - 37
publisher
Taylor & Francis
external identifiers
  • pmid:34736369
  • scopus:85118577050
ISSN
0284-186X
DOI
10.1080/0284186X.2021.1992006
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 Acta Oncologica Foundation.
id
6f4eaca1-d8b5-44b3-8087-1c26670f013d
date added to LUP
2021-12-02 11:19:22
date last changed
2024-04-06 14:24:35
@article{6f4eaca1-d8b5-44b3-8087-1c26670f013d,
  abstract     = {{<p>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 &gt; 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 &gt; 32 d for surgery and 1098 &gt; 70 d. The overall median wait time was 44 d. The factors most strongly associated with a wait time &gt; 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 &lt; 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.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.</p>}},
  author       = {{Marcickiewicz, Janusz and Åvall-Lundqvist, Elisabeth and Holmberg, Erik Carl Viktor and Borgfeldt, Christer and Bjurberg, Maria and Dahm-Kähler, Pernilla and Flöter-Rådestad, Angelique and Hellman, Kristina and Högberg, Thomas and Rosenberg, Per and Stålberg, Karin and Kjølhede, Preben}},
  issn         = {{0284-186X}},
  keywords     = {{delay; Endometrial cancer; time to surgery; time to treatment; wait time}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{30--37}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Oncologica}},
  title        = {{The wait time to primary surgery in endometrial cancer–impact on survival and predictive factors : a population-based SweGCG study}},
  url          = {{http://dx.doi.org/10.1080/0284186X.2021.1992006}},
  doi          = {{10.1080/0284186X.2021.1992006}},
  volume       = {{61}},
  year         = {{2022}},
}