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Waiting for radiotherapy in ontario
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Proceedings of the 36th Annual ASTRO Meeting
1099 WAITING FOR RADIOTHERAPY IN CANADA AND THE U.S.A. Quirt, Carol F.‘, Mackillop, William J.‘, Zhou, Yunzheng’, and O’Sullivan, Brian’ Radiation Oncology Research Unit’, Queen’s University’, Kingston Regional Cancer Centre’, Kingston General HospitaJ’, Kingston and Princess Margaret Hospital/Ontario Cancer Institute’, Toronto, Ontario, Canada Purpose/Objectives: To describe a) how long patients wait for radiotherapy in Canada and the USA, and b) how long radiation oncologists believe it is acceptable for them to wait. Materials and Methods: Heads of all radiation oncology departments in Canada (n=27) and all U.I.C.C. listed comprehensive cancer centers in the U.S.A. which had a radiation oncology program (n=69) were sent a questionnaire asking about staffing, equipment, and waiting times for radiotherapy. Six cases were described and the respondent was asked how long each would wait to start radiotherapy after referral to a radiation oncologist in his or her department. In each case, the respondent was also asked what he or she thought was the maximum medically acceptable interval between referral to a radiation oncologist and the start of radiotherapy. Results: Eighty-nine of the 96 eligible centers completed the questionnaire (93% compliance). The mean numbers of new radiotherapy cases treated each year per staff member and per machine were as follows: cases/lo,, Canada-244, USA-169; cases/physicist, Canada-384, USA-266; cases/RTT, Canada-67, USA-82; cases/simulator, Canada-1028, USA-471; cases/megavoltage unit, Canada-359, USA-248. Median waiting times from referral to radiotherapy for these six clinical problems were as follows: T,N& larynx, Canada 29 days, USA 10 days; Stage IIIb NSCLC, Canada 34 days, USA 10 days; Stage B, prostate, Canada 43 days, USA 11 days; T,N& breast referred one month post-lumpectomy, Canada 44 days, USA 10 days; painful bone metastases, Canada 17 days, USA 5 days; spinal cord compression, Canada < 1 day, USA < 1 day. Except in the case of cord compression, the difference in waiting times between Canada and the USA were all highly statistically significant @
1100 WAITING FOR RADIOTHERAPY IN ONTARIO Mackillop, William J.. Fu, Henry, Quirt, Carol F., Dixon, Peter, Brundage, Michael, and Zhou, Yunzheng The Radiation Oncology Research Unit, Queen’s University, Kingston Regional Cancer Centre, and Kingston General Hospital, Kingston, Ontario, Canada Purpose/Objective: Waiting lists for radiotherapy are a fact of life at many Canadian cancer centers. a detailed description of the magnitude of the problem in the province of Ontario.
The purpose of this study was to provide
Materials and Methods: The computerized data base of the Ontario Cancer Foundation was used to calculate the interval between diagnosis and initiation of radiation treatment for all patients receiving primary radiotherapy for carcinoma of the larynx, cervix, and prostate or post-operative radiotherapy for carcinoma of the breast at seven Ontario cancer centers between 1982 and 1993. Results: Median waiting times between diagnosis and initiation of radical treatment for carcinoma of the larynx (n= 1673), carcinoma of the cervix (n = 1199), and carcinoma of the prostate (n =3225) were 33 days, 28 days, and 99 days respectively for the full 12 year period. The exceptional interval between the diagnosis and treatment of prostate cancer was due to much longer delays between diagnosis and referral to a radiation oncologist. The median waiting time between the diagnosis and initiation of post-operative radiotherapy for breast cancer (n=6222) was 64 days and the median time between the completion of surgery and initiation of post-operative radiotherapy was 59 days. There were significant inter-center variations in median waiting times, but in each disease the median waiting time in Ontario as a whole increased steadily between 1982 and 1993. Between 1982 and 1993, the median waiting times from diagnosis to the start of treatment increased from 15 to 41.5 days for laryngeal cancer, from 17.5 to 34.5 days for cervical cancer, and from 62 to 103 days for prostate cancer. Waiting time from completion of surgery to initiation of post-operative radiotherapy for breast cancer increased from 34 to 69 days. All of these increases were highly statistically significant (p < 0.0001). Most of the increase in treatment delay was found in the interval between the patient’s first consultation with a radiation oncologist and initiation of radiotherapy. Conclusions: The Committee on Standards of the Canadian Association of Radiation Oncologists recommends that the interval between referral and consultation should not exceed 2 weeks and that the interval between consultation and initiation of radiotherapy should also not exceed 2 weeks. The majority of patients treated in Ontario met both those standards in 1982, but by 1993 few patients received care within the prescribed intervals. We conclude that radiation oncologists should be more actively involved in planning programs of care for cancer patients, and that health care programs must become more accountable to the consumer if Ontario’s single payer system is to provide adequate access to high quality care.
Proceedings of the 36th Annual ASTRO Meeting
1099 WAITING FOR RADIOTHERAPY IN CANADA AND THE U.S.A. Quirt, Carol F.‘, Mackillop, William J.‘, Zhou, Yunzheng’, and O’Sullivan, Brian’ Radiation Oncology Research Unit’, Queen’s University’, Kingston Regional Cancer Centre’, Kingston General HospitaJ’, Kingston and Princess Margaret Hospital/Ontario Cancer Institute’, Toronto, Ontario, Canada Purpose/Objectives: To describe a) how long patients wait for radiotherapy in Canada and the USA, and b) how long radiation oncologists believe it is acceptable for them to wait. Materials and Methods: Heads of all radiation oncology departments in Canada (n=27) and all U.I.C.C. listed comprehensive cancer centers in the U.S.A. which had a radiation oncology program (n=69) were sent a questionnaire asking about staffing, equipment, and waiting times for radiotherapy. Six cases were described and the respondent was asked how long each would wait to start radiotherapy after referral to a radiation oncologist in his or her department. In each case, the respondent was also asked what he or she thought was the maximum medically acceptable interval between referral to a radiation oncologist and the start of radiotherapy. Results: Eighty-nine of the 96 eligible centers completed the questionnaire (93% compliance). The mean numbers of new radiotherapy cases treated each year per staff member and per machine were as follows: cases/lo,, Canada-244, USA-169; cases/physicist, Canada-384, USA-266; cases/RTT, Canada-67, USA-82; cases/simulator, Canada-1028, USA-471; cases/megavoltage unit, Canada-359, USA-248. Median waiting times from referral to radiotherapy for these six clinical problems were as follows: T,N& larynx, Canada 29 days, USA 10 days; Stage IIIb NSCLC, Canada 34 days, USA 10 days; Stage B, prostate, Canada 43 days, USA 11 days; T,N& breast referred one month post-lumpectomy, Canada 44 days, USA 10 days; painful bone metastases, Canada 17 days, USA 5 days; spinal cord compression, Canada < 1 day, USA < 1 day. Except in the case of cord compression, the difference in waiting times between Canada and the USA were all highly statistically significant @
1100 WAITING FOR RADIOTHERAPY IN ONTARIO Mackillop, William J.. Fu, Henry, Quirt, Carol F., Dixon, Peter, Brundage, Michael, and Zhou, Yunzheng The Radiation Oncology Research Unit, Queen’s University, Kingston Regional Cancer Centre, and Kingston General Hospital, Kingston, Ontario, Canada Purpose/Objective: Waiting lists for radiotherapy are a fact of life at many Canadian cancer centers. a detailed description of the magnitude of the problem in the province of Ontario.
The purpose of this study was to provide
Materials and Methods: The computerized data base of the Ontario Cancer Foundation was used to calculate the interval between diagnosis and initiation of radiation treatment for all patients receiving primary radiotherapy for carcinoma of the larynx, cervix, and prostate or post-operative radiotherapy for carcinoma of the breast at seven Ontario cancer centers between 1982 and 1993. Results: Median waiting times between diagnosis and initiation of radical treatment for carcinoma of the larynx (n= 1673), carcinoma of the cervix (n = 1199), and carcinoma of the prostate (n =3225) were 33 days, 28 days, and 99 days respectively for the full 12 year period. The exceptional interval between the diagnosis and treatment of prostate cancer was due to much longer delays between diagnosis and referral to a radiation oncologist. The median waiting time between the diagnosis and initiation of post-operative radiotherapy for breast cancer (n=6222) was 64 days and the median time between the completion of surgery and initiation of post-operative radiotherapy was 59 days. There were significant inter-center variations in median waiting times, but in each disease the median waiting time in Ontario as a whole increased steadily between 1982 and 1993. Between 1982 and 1993, the median waiting times from diagnosis to the start of treatment increased from 15 to 41.5 days for laryngeal cancer, from 17.5 to 34.5 days for cervical cancer, and from 62 to 103 days for prostate cancer. Waiting time from completion of surgery to initiation of post-operative radiotherapy for breast cancer increased from 34 to 69 days. All of these increases were highly statistically significant (p < 0.0001). Most of the increase in treatment delay was found in the interval between the patient’s first consultation with a radiation oncologist and initiation of radiotherapy. Conclusions: The Committee on Standards of the Canadian Association of Radiation Oncologists recommends that the interval between referral and consultation should not exceed 2 weeks and that the interval between consultation and initiation of radiotherapy should also not exceed 2 weeks. The majority of patients treated in Ontario met both those standards in 1982, but by 1993 few patients received care within the prescribed intervals. We conclude that radiation oncologists should be more actively involved in planning programs of care for cancer patients, and that health care programs must become more accountable to the consumer if Ontario’s single payer system is to provide adequate access to high quality care.