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Efficiency of colorectal cancer care among veterans: analysis of treatment wait times at Veterans Affairs Medical Centers.

Publication ,  Journal Article
Merkow, RP; Bilimoria, KY; Sherman, KL; McCarter, MD; Gordon, HS; Bentrem, DJ
Published in: J Oncol Pract
July 2013

PURPOSE: Timeliness of cancer treatment is an important aspect of health care quality. Veterans Affairs Medical Centers (VAMCs) are expected to treat a growing number of patients with cancer. Our objectives were to examine treatment times from diagnosis to first-course therapy for patients with colon and rectal cancers and assess factors associated with prolonged wait times. METHODS: From the VA Central Cancer Registry, patients who underwent colon or rectal resection for cancer from 1998 to 2008 were identified. Time from diagnosis to definitive cancer-directed therapy was measured, and multivariable regression methods were used to determine predictors of prolonged wait times for colon (≥ 45 days) and rectal (≥ 60 days) cancers. RESULTS: From 124 VAMCs, 14,097 patients underwent colectomy, and 3,390 underwent rectal resection for cancer. For colon cancer, the median time to treatment increased by 68% over time (P < .001). From 2007 to 2008, the median time to colectomy was 32 days. Predictors of prolonged wait times included age ≥ 55 years (v < 55 years), time period (2007 to 2008 v 1998 to 2000), black race (v white), marriage status (married v unmarried), high-volume center status (v low volume), and treatment at a different hospital (v same hospital as initial diagnosis; all P < .05). For rectal cancer, the overall median time to first-course treatment increased by 74% (P < .001). From 2007 to 2008, the median time to proctectomy was 47 days. Similar predictors of prolonged wait times were identified for rectal cancer. CONCLUSION: Time to first treatment has increased for patients with colon and rectal cancers at VAMCs. Patient, tumor, and hospital factors are associated with prolonged time to treatment.

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Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

July 2013

Volume

9

Issue

4

Start / End Page

e154 / e163

Location

United States

Related Subject Headings

  • Veterans
  • Time-to-Treatment
  • Time Factors
  • Tertiary Care Centers
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Merkow, R. P., Bilimoria, K. Y., Sherman, K. L., McCarter, M. D., Gordon, H. S., & Bentrem, D. J. (2013). Efficiency of colorectal cancer care among veterans: analysis of treatment wait times at Veterans Affairs Medical Centers. J Oncol Pract, 9(4), e154–e163. https://doi.org/10.1200/JOP.2012.000738
Merkow, Ryan P., Karl Y. Bilimoria, Karen L. Sherman, Martin D. McCarter, Howard S. Gordon, and David J. Bentrem. “Efficiency of colorectal cancer care among veterans: analysis of treatment wait times at Veterans Affairs Medical Centers.J Oncol Pract 9, no. 4 (July 2013): e154–63. https://doi.org/10.1200/JOP.2012.000738.
Merkow RP, Bilimoria KY, Sherman KL, McCarter MD, Gordon HS, Bentrem DJ. Efficiency of colorectal cancer care among veterans: analysis of treatment wait times at Veterans Affairs Medical Centers. J Oncol Pract. 2013 Jul;9(4):e154–63.
Merkow, Ryan P., et al. “Efficiency of colorectal cancer care among veterans: analysis of treatment wait times at Veterans Affairs Medical Centers.J Oncol Pract, vol. 9, no. 4, July 2013, pp. e154–63. Pubmed, doi:10.1200/JOP.2012.000738.
Merkow RP, Bilimoria KY, Sherman KL, McCarter MD, Gordon HS, Bentrem DJ. Efficiency of colorectal cancer care among veterans: analysis of treatment wait times at Veterans Affairs Medical Centers. J Oncol Pract. 2013 Jul;9(4):e154–e163.

Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

July 2013

Volume

9

Issue

4

Start / End Page

e154 / e163

Location

United States

Related Subject Headings

  • Veterans
  • Time-to-Treatment
  • Time Factors
  • Tertiary Care Centers
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Humans