Cancer treatment delays surge across US as doctor warns system ‘needs fixing immediately’

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Wait times between acancer diagnosisand the start of treatment grew by nearly two weeks over the past decade in the U.S., according to a recent study published in JAMA Surgery.

Researchers from the University of California, Los Angeles and Massachusetts General Hospital analyzed national data from more than two million patients diagnosed between January 2012 and December 2023.

The study tracked adults with early to locally advanced stages of six common cancers (breast,colon, lung, pancreatic, stomach and esophageal) who received surgery as part of their initial care.

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Researchers measured wait times from the day of the diagnosis to the first treatment, whether that was asurgeryor pre-surgical therapy designed to shrink a tumor.

Across all six cancer types, median wait times grew by more than 10 days over the study period, regardless of whether surgery came first or followed other treatments.

woman rings a ceremonial bell in a treatment office.

Using National Cancer Database data from 2012 to 2023, researchers evaluated treatment delays in a cohort of over 2.7 million U.S.patients.(iStock)

The longest increases occurred in stomach cancer, where wait times rose from 35 days to 49 days, and lung cancer, which increased from 41 days to 53 days.Breast cancerwait times grew from 34 to 45 days, while colon cancer delays increased from 20 to 31 days.

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Pancreatic cancerwaits climbed from 23 to 32 days, and esophageal cancer delays grew from 38 to 48 days.The researchers also found that a growing share of patients waited 60 days or longer to begin treatment.

“This is part of ourhealthcare systemthat needs fixing immediately,” Dr.

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The delays were even seen at high-volume academic medical centers, noted Siegel, who was not involved in the study.

“The waiting times for basic cancer operations in non-metastatic diseases is high and increasing since 2012,” he added.

Hospital staff assist patients at front desk in emergency waiting area.

Median waiting times from diagnosis to the start of first-course therapy increased by more than 10 days across all six evaluated cancer types over the study period.(iStock)

After adjusting for factors like age andunderlying health, researchers found the delays did not affect all groups in the same way.

Longer wait times were seen for Black patients, people on Medicaid, individuals in lower-income areas, patients traveling longer distances for care, and those treated at academic medical centers or high-volume hospitals.

The West experienced longer delays than other regions, and for non-breast cancers, the use of robotic surgery was linked to longer wait times.

The study authors cautioned that delays in surgical treatment have been tied to higher death rates and worse long-term survival in previousmedical research.

Senior woman battling cancer sits in high-back chair talking with her oncologist during chemotherapy treatment.

The study authors cautioned that delays in surgical treatment have been tied to higher death rates and worse long-term survival in previous medical research.(iStock)

In supporting commentary published along with the study, Lia D.Delaney, M.D., and Sherry M.Wren, M.D., both of the Stanford School of Medicine in Palo Alto, California, emphasized that cancer care has become increasingly sophisticated over the last two decades.

However, “ascancer carecontinues to regionalize, efforts to improve quality may inadvertently create barriers to timely treatment unless capacity and coordination evolve in parallel,” they wrote.

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The authors noted several limitations to their study.Because the analysis relied on retrospective data from the National Cancer Database, it could not determine the exact reasons behind individual treatment delays, such as scheduling issues, logistical hurdles or personal patient preferences.

The database also lacked information on when patients first developed symptoms or soughtmedical adviceprior to diagnosis.

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