scholarly journals Wait Times for Diagnostic Colonoscopy among Outpatients with Colorectal Cancer: A Comparison with Canadian Association of Gastroenterology Targets

2012 ◽  
Vol 26 (12) ◽  
pp. 894-896 ◽  
Author(s):  
Michael Sai Lai Sey ◽  
Jamie Gregor ◽  
Paul Adams ◽  
Nitin Khanna ◽  
Chris Vinden ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Significant Proportion ◽  
Wait Time ◽  
Wait Times ◽  
Cancer Stage ◽  
Exclusion Criteria ◽  
Diagnostic Colonoscopy ◽  
Canadian Association ◽  
Timely Access ◽  
Colorectal Cancer Patients

BACKGROUND: Timely access to colonoscopy is a nationally recognized issue in Canada, with previous studies documenting significant wait times for a variety of indications. However, specific wait times for colonoscopy among patients diagnosed with colorectal cancer remain unknown.METHODS: A review of all outpatient cases of colorectal cancer diagnosed at colonoscopy in London, Ontario, in 2010 was performed. Wait times from the date of referral to colonoscopy were reviewed and compared with maximal wait times established by the Canadian Association of Gastroenterology (CAG) stratified according to indication. Cancer stage at the time of diagnosis was compared with colonoscopy wait times.RESULTS: A total of 106 colorectal cancer patients meeting the inclusion and exclusion criteria were included in the study. Forty-six per cent of patients waited longer than CAG targets, with a mean (± SD) wait time of 79±101 days. Higher cancer stage was associated with shorter wait time, likely as a result of triaging.CONCLUSION: Long wait times for diagnostic colonoscopy among patients with colorectal cancer remain an issue, with a significant proportion of cases not meeting maximal CAG wait time targets.

scholarly journals Time to Endoscopy in Patients with Colorectal Cancer: Analysis of Wait-Times

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Renée M. Janssen ◽  
Oliver Takach ◽  
Estello Nap-Hill ◽  
Robert A. Enns
Keyword(s):  
Colorectal Cancer ◽  
Retrospective Chart Review ◽  
Wait Time ◽  
Office Visit ◽  
Distant Metastases ◽  
Endoscopic Examination ◽  
Wait Times ◽  
Canadian Association ◽  
The Mean ◽  
Current Guidelines

Objective. The Canadian Association of Gastroenterology Wait Time Consensus Group recommends that patients with symptoms associated with colorectal cancer (CRC) should have an endoscopic examination within 2 months. However, in a recent survey of Canadian gastroenterologists, wait-times for endoscopy were considerably longer than the current guidelines recommend. The purpose of this study was to evaluate wait-times for colonoscopy in patients who were subsequently found to have CRC through the Division of Gastroenterology at St. Paul’s Hospital (SPH).Methods. This study was a retrospective chart review of outpatients seen for consultation and endoscopy ultimately diagnosed with CRC. Subjects were identified through the SPH pathology database for the inclusion period 2010 through 2013. Data collected included wait-times, subject characteristics, cancer characteristics, and outcomes.Results. 246 subjects met inclusion criteria for this study. The mean wait-time from primary care referral to first office visit was 63 days; the mean wait-time to first endoscopy was 94 days. Patients with symptoms waited a mean of 86 days to first endoscopy, considerably longer than the national recommended guideline of 60 days. There was no apparent effect of length of wait-time on node positivity or presence of distant metastases at the time of diagnosis.Conclusion. Wait-times for outpatient consultation and endoscopic evaluation at the St. Paul’s Hospital Division of Gastroenterology exceed current guidelines.

scholarly journals Wait Times for Gastroenterology Consultation in Canada: The Patients’ Perspective

2010 ◽  
Vol 24 (1) ◽  
pp. 28-32 ◽  
Author(s):  
WG Paterson ◽  
AN Barkun ◽  
WM Hopman ◽  
DJ Leddin ◽  
P Paré ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Gastrointestinal Symptoms ◽  
Wait Time ◽  
Wait Times ◽  
Canadian Association ◽  
Serious Disease ◽  
One Year ◽  
Patients Experience ◽  
Impaired Quality

Long wait times for health care have become a significant issue in Canada. As part of the Canadian Association of Gastroenterology’s Human Resource initiative, a questionnaire was developed to survey patients regarding wait times for initial gastroenterology consultation and its impact. A total of 916 patients in six cities from across Canada completed the questionnaire at the time of initial consultation. Self-reported wait times varied widely, with 26.8% of respondents reporting waiting less than two weeks, 52.4% less than one month, 77.1% less than three months, 12.5% reported waiting longer than six months and 3.6% longer than one year. One-third of patients believed their wait time was too long, with 9% rating their wait time as ‘far too long’; 96.4% believed that maximal wait time should be less than three months, 78.9% believed it should be less than one month and 40.3% believed it should be less than two weeks. Of those working or attending school, 22.6% reported missing at least one day of work or school because of their symptoms in the month before their appointment, and 9.0% reported missing five or more days in the preceding month. A total of 20.2% of respondents reported being very worried about having a serious disease (ie, scored 6 or higher on 7-point Likert scale), and 17.6% and 14.8%, respectively, reported that their symptoms caused major impairment of social functioning and with the activities of daily living. These data suggest that a significant proportion of Canadians with digestive problems are not satisfied with their wait time for gastroenterology consultation. Furthermore, while awaiting consultation, many patients experience an impaired quality of life because of their gastrointestinal symptoms.

scholarly journals Analysis of variations in anesthesia cost according to severity of physical status and cancer stage in colorectal cancer patients

2018 ◽  
Vol 13 (4) ◽  
pp. 454-462
Author(s):  
Joo Young Song ◽  
Ji Man Kim ◽  
Jaeyong Shin ◽  
Sang Gyu Lee ◽  
Tae Hyun Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Cancer Stage ◽  
Physical Status ◽  
Colorectal Cancer Patients

scholarly journals P.017 Results of a Pilot feasibility study to develop reduce wait times strategy in the evaluation of children with new onset epilepsy

2018 ◽  
Vol 45 (s2) ◽  
pp. S20-S20
Author(s):  
JA Mailo ◽  
M Diebold ◽  
E Mazza ◽  
P Guertjens ◽  
H Gangam ◽  
...  
Keyword(s):  
Patient Flow ◽  
Waiting Times ◽  
Wait Time ◽  
Febrile Seizures ◽  
Limiting Factors ◽  
Wait Times ◽  
Timely Access ◽  
Flow Through ◽  
Pilot Feasibility Study ◽  
New Onset

Background: The goal was to understand factors leading to prolonged wait times for neurological assessment of children with new onset seizures. A second objective was to develop an innovative approach to patient flow through and achieve a reduction in waiting times utilizing limited resources.Methods:Audit of the referrals, flow through, wait timesIdentification of bottlenecksDevelopment of triaging strategy:Suspected Febrile seizures and non-epileptic events;Suspected benign and absence epilepsies;Suspected other Focal epilepsies, generalized epilepsies, epilepsy under 2 yearsInitiation of early telephone contact and supportDevelopment of a ketogenic dietResults: Using a triaging strategy and focusing on timely access to investigations, wait times for clinic evaluations were shortened despite larger numbers of referrals (mean wait time reductions from 179 to 91 days). Limiting factors such increase in referral numbers, attrition in support staff, interfered with sustainability of reduced wait times achieved in the initial phase of the program. Conclusions: This pilot study highlights the effectiveness of an innovative triaging strategy and improvements in patient flow through in achieving the goals of reduction in wait times for clinical evaluation and timely investigations to improve care for children with new onset seizures. Insights into limitations of such strategies and factors determining sustainability are discussed.

scholarly journals Palliative chemotherapy in advanced colorectal cancer patients 80 years of age and older

2016 ◽  
Vol 23 (3) ◽  
pp. 144 ◽  
Author(s):  
P. Lai ◽  
S. Sud ◽  
T. Zhang ◽  
T. Asmis ◽  
P. Wheatley-Price
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
White Blood Cells ◽  
Significant Proportion ◽  
Retrospective Chart Review ◽  
Assessment Tools ◽  
Prescription Medications ◽  
Patient Demographics ◽  
Few Data ◽  
Colorectal Cancer Patients

Background Colorectal cancer (CRC) has a median diagnostic age of 68 years. Despite significant progress in chemotherapy (CTX) options, few data on outcomes or toxicity from ctx in patients 80 years of age and older are available. We investigated CTX in such patients with metastatic CRC (MCRC), hypothesizing high rates of hospitalization and toxicity. MethodsA retrospective chart review identified patients 80 years of age and older with MCRC who initiated CTX between 2005–2010 at our institution. Patient demographics and CTX data were collected. Endpoints included rates of hospitalization, CTX discontinuation because of toxicity, and overall survival. ResultsIn 60 patients, CTX was initiated on 88 occasions. Median age in the cohort was 83 years; 52% were men; 72% lived with family; 53% had a modified Charlson comorbidity index of 2 or greater; and 31% were taking 6 or more prescription medications at baseline. At baseline, 33% of the patients were anemic (hemoglobin < 100 g/L), 36% had leukocytosis (white blood cells > 11×109/L), and 48% had renal impairment (estimated glomerular filtration rate < 60 mL/min/1.73 m2). In 53%, CTX was given as first-line treatment. The initial CTX dose was adjusted in 67%, and capecitabine was the most common chemotherapeutic agent (45%). In 19 instances (22%), the patient was hospitalized during or within 30 days of CTX; in 26 instances (30%), the CTX was discontinued because of toxicity, and in 48 instances (55%), the patient required at least 1 dose reduction, omission, or delay. Median overall survival was 17.8 months (95% confidence interval: 14.3 to 20.8 months).ConclusionsIn the population 80 years of age and older, CTX for MCRC is feasible; however, most recipients will require dose adjustments, and a significant proportion will be hospitalized or stop CTX because of toxicity. Prospective research incorporating geriatric assessment tools is required to better select these older patients for CTX.

scholarly journals High incidence of prolonged rectal bleeding and advanced stage cancer in early-onset colorectal cancer patients

2020 ◽  
Vol 9 (3) ◽  
pp. CRC31
Author(s):  
Gurprataap Singh Sandhu ◽  
Rebekah Anders ◽  
Patrick Blatchford ◽  
Amy Walde ◽  
Alexis Leal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Bleeding ◽  
Early Onset ◽  
Primary Care Physicians ◽  
Significant Proportion ◽  
Stage Iv ◽  
Colorectal Cancer Patients ◽  
Advanced Stage Cancer ◽  
Bleeding History ◽  
Early Onset Colorectal Cancer

Background: We examined characteristics of early-onset colorectal cancer (CRC) patients to identified factors, which may lead to earlier diagnosis. Materials & methods: This is a retrospective study with inclusion criteria: CRC diagnosed between 2012 and 2018 and age at diagnosis <50 years. Results: A total of 209 patients were included (mean age 41.8 years). Of those patients 42.5% had rectal cancer and 37.8% were stage IV at initial diagnosis. Of patients with data available for rectal bleeding history (n = 173), 50.8% presented with rectal bleeding and median time from onset of bleeding to diagnosis was 180 days (interquartile range 60–365), with longer duration noted in advanced cancer. Conclusion: Prolonged rectal bleeding history was noted in a significant proportion of early-onset CRC patients, with longer duration of rectal bleeding noted in stage IV patients. Patients and primary care physicians should be made aware of this finding in order to facilitate timely referral for diagnostic workup.

scholarly journals Wait Time for Endoscopic Evaluation at a Canadian Tertiary Care Centre: Comparison with Canadian Association of Gastroenterology Targets

2008 ◽  
Vol 22 (7) ◽  
pp. 621-626 ◽  
Author(s):  
Derek Yu ◽  
Wilma M Hopman ◽  
William G Paterson
Keyword(s):  
Tertiary Care ◽  
Gastrointestinal Symptoms ◽  
Wait Time ◽  
Final Diagnosis ◽  
Screening Colonoscopy ◽  
Deficiency Anemia ◽  
Wait Times ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Canadian Association

BACKGROUND: In recent years, there has been considerable concern regarding wait times for Canadian health care, which led the Canadian Association of Gastroenterology (CAG) to develop specific wait time targets.OBJECTIVES: To quantify wait times for endoscopic procedures at a tertiary care centre and correlate these with clinical presentation, impact on quality of life (QOL) and final diagnosis; and to determine how well the CAG wait time targets are being met.METHODS: Patients completed a 12-item questionnaire regarding wait times and their impact on QOL. A blind review was performed of the endoscopic results, with a specific focus on correlating wait time with a final diagnosis of serious and treatable diseases.RESULTS: The average total wait time for the 417 participants in the present study was 229 days; 78.6% did not meet CAG wait time targets. The wait time for screening colonoscopy was longer, and the proportion of patients meeting wait time targets was significantly smaller, than for patients referred with iron deficiency anemia or a positive fecal occult blood test result. The 41 patients deemed to have a high-impact diagnosis established by endoscopy had a median wait time of 115 days, and only 23.5% met wait time targets. Overall, 38.4% of patients believed that their wait was too long, 13.9% missed school or work in the preceding month because of gastrointestinal symptoms and 23% reported being very worried about having a serious disease.CONCLUSIONS: The majority of patients waiting for endoscopy did not meet CAG wait time targets, with the screening colonoscopy group faring the worst. Many of these patients await a definitive diagnosis of serious diseases that negatively impact QOL.

scholarly journals Wait times in prostate cancer diagnosis and radiation treatment

2013 ◽  
Vol 4 (4) ◽  
pp. 243
Author(s):  
Christiaan Stevens ◽  
Susan J. Bondy ◽  
D. Andrew Loblaw
Keyword(s):  
Prostate Cancer ◽  
Cancer Diagnosis ◽  
Radiation Treatment ◽  
Wait Time ◽  
Diagnosis And Treatment ◽  
Prise En Charge ◽  
Wait Times ◽  
Treatment Area ◽  
Canadian Association ◽  
Definitive Therapy

Introduction: Wait times for cancer diagnosis and treatment area significant concern for Canadians. Men with prostate cancerexperience longer waiting times for diagnosis and treatment thanthose observed for other cancers. Longer waits are associated withboth patient and family psychosocial distress and may be associatedwith worse prognosis.Methods: Men referred for treatment of prostate cancer at a singleCanadian cancer centre were interviewed. The intervals from suspicionto definitive therapy were calculated, factors associated withdelays along this pathway were identified, and common causes ofdelay identified by patients were described.Results: A total of 41 consecutive patients participated. The medianinterval from suspicion to the first fraction of radiotherapy forall patients was 247 days (interquartile range [IQR] 168-367 d).The median diagnostic interval was 53 days (IQR 28-166 d). Themedian treatment interval was 127 days (IQR 100-180 d). Patientsunder 70 years old and patients with <T2c disease had shorterintervals from suspicion to treatment. From diagnosis to start ofradiotherapy, patients with low-risk disease had longer intervals.Seventy percent of patients perceived a delay in their care, ofwhich 45%, 31% and 24% of patients felt the delays were due tothe health care system, patient or physician factors, respectively.Interpretation: In this study, 12% and 0% of patients met CanadianStrategy for Cancer Control and Canadian Association of RadiationOncologists wait time recommendations, respectively. A large componentof wait time is patient driven. Alternate strategies shouldbe developed and measured to shorten the intervals between thesuspicion and treatment of prostate cancer.Introduction : Les temps d’attente pour recevoir un diagnosticde cancer et un traitement constituent une source importante depréoccupation pour les Canadiens. Les hommes atteints de cancerde la prostate attendent encore plus longtemps que les patientsatteints d’autres types de cancer pour obtenir un diagnostic etentreprendre un traitement. Ces attentes plus longues se traduisentpour le patient et sa famille par un stress psychosocial et peuventêtre liés à un pronostic plus sombre.Méthodologie : Des hommes aiguillés vers le même centre decancérologie au Canada pour la prise en charge d’un cancer dela prostate ont été interviewés. L’intervalle entre le soupçon decancer et le début réel du traitement a été calculé; on a cernéles facteurs liés aux retards le long du processus, et les causes deretards signalées par les patients ont été décrites.Résultats : Au total, 41 patients consécutifs ont participé. La duréemédiane de l’intervalle entre le soupçon de cancer et la premièreséance de radiothérapie pour tous les patients était de 247 jours(écart interquartile [EIQ], 168 à 367 jours). La durée médianede l’intervalle avant le diagnostic était de 53 jours (EIQ, 28 à166 jours). La durée médiane de l’intervalle avant le début dutraitement était de 127 jours (EIQ, 100 à 180 jours). Les patients deplus de 70 ans et les patients porteurs d’une tumeur T2c ou moinsavancée signalaient des intervalles plus courts entre les premierssoupçons de cancer et le traitement. Entre le diagnostic et le débutde la radiothérapie, les patients présentant une maladie à faiblerisque avaient des intervalles plus longs. Soixante-dix pour centdes patients ont perçu un retard dans leur prise en charge, parmilesquels 45 % croyaient ce retard lié au système de santé, 31 %, àdes facteurs liés au patient, et 24 %, à des facteurs liés au médecin.Interprétation : Dans cette étude, 12 % et 0 % des patients,respectivement, ont présenté des temps d’attentes conformes auxrecommandations de la Stratégie canadienne de lutte contre lecancer et de l’Association canadienne de radio-oncologie. Letemps d’attente est déterminé en grande partie par des facteurs liésau patient. D’autres stratégies devraient être élaborées et évaluéesafin de réduire les intervalles entre les premiers soupçons de cancerde la prostate et le début du traitement.

Sign in / Sign up

Export Citation Format

Share Document