Pancreatic cancer: Wait times from presentation to treatment and survival in a population‐based study. Issue 5 (14th May 2016)

• Record Type: Journal Article
• Authors: Jooste, Valérie; Dejardin, Olivier; Bouvier, Véronique; Arveux, Patrick; Maynadie, Marc; Launoy, Guy; Bouvier, Anne‐Marie
• Is Part Of: International journal of cancer. Volume 139:Issue 5(2016:Sep. 01)
• Page Start: 1073
• Page End: 1080
• Publication Date: 2016-05-14
• Subjects: pancreatic cancer -- patient delay -- treatment delay -- survival -- epidemiology -- cancer registry; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.30166
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Pancreatic survival is one of the worst in oncology. To what extent wait times affect outcomes in unknown No population‐based study has previously explored patient and treatment delays among individuals with pancreatic cancer. The aim of this study was to estimate patient and treatment delays in patients with pancreatic cancer and to measure their association with survival in a nonselected population. All patients diagnosed with pancreatic cancer for the first time between 2009 and 2011 and registered in two French digestive cancer registries were included. Patient delay (time from onset of symptoms until the first consultation categorized into <1 or ≥1 month), and treatment delay (time between the first consultation and treatment categorized into less or more than 29 days, the median time) were collected. Overall delay was used to test associations between survival and the timeliness of care by combining patient delay and treatment delay. Patient delay was longer than 1 month in 46% of patients. A patient delay longer than one month was associated with the absence of jaundice ( p < 0.001) and the presence of metastasis ( p = 0.003). After adjusting for other covariates, such as symptoms and treatment, the presence of metastasis was negatively associated with treatment delay longer than 29 days ( p = 0.025). After adjustment for other covariates, especially metastatic dissemination and the result of the resection, overall delay was not significantly associated with prognosis. We found little evidence to suggest that timely care was associated with the survival of patients. Abstract : What's new? Survival rates for pancreatic cancer remain exceedingly low. But while the disease often is not detected until advanced stages, whether delays in seeking physician care and in receiving treatment contribute to poor survival is unclear. In this population‐based study in France, the presence of jaundice and metastatic dissemination were the two most relevant factors related to the timeliness of care, causing patients to consult a physician and being associated with short treatment delays. Nonetheless, timeliness of care had no impact on survival. The findings suggest that the advance of novel therapeutics will be key to improving pancreatic cancer survival.