Quality Assurance in Cancer. Acceptable delays to decide the therapeutic plan in breast cancer and colorectal cancer.
DOI:
https://doi.org/10.23938/ASSN.0094Keywords:
Cáncer colorrectal. Cáncer de mama. Protocolos tratamiento cáncer. Calidad asistencial.Abstract
Objective: To determine recommended delays for treatment since there is a clinical suspicion for cancer care processes breast and colorectal taking into account resources and psychological well-being of the patients. Method: A qualitative study among professionals. The study was conducted in two phases. Firstly, during 4 sessions (N=19) we conducted a revision of the care processes of breast cancer and colorectal cancer and fixed desirable times. Secondly, through a modification of the Delphi technique (N=49), the propose times for each care process were validated. Results: Delphi’s response rate of 69% and 58% for colorectal and breast process respectively. The recommended time in the case of not invasive breast cancer was 5 to 6 weeks. For invasive cancer and nuclear medicine for sentinel node study was necessary, and in the case of invasive breast cancer with axillary clearance 5 to 7 weeks. In the case of cancer of the colon and rectum was considered necessary from 7 to 13 weeks. Conclusions: There is a possibility of shortening the time to confirm the diagnosis and treatment plan in the processes of breast cancer and colorectal cancer considering current resources.Downloads
References
1. MIRA JJ. La satisfacción del paciente: teorías, medidas y resultados. Todo Hospital 2006: 224: 90-97.
2. LONGTIN Y, SAX H, LEAPE L, SHERIDAN SE, DONALDSON L, PITTET D. Patient participation: Current knowledge and applicability to patient safety. Mayo Clin Proc 2010; 85: 53-62.
https://doi.org/10.4065/mcp.2009.0248
3. ARRARÁS JI, ARIAS DE LA VEGA F, ILLARRAMENDI JJ, MANTEROLA A, SALGADO E, DOMÍNGUEZ MA,VERA R. Calidad de vida relacionada con la salud en los servicios de Oncología del Hospital de Navarra. Grupo de Calidad de Vida de la EORTC. An Sist Sanit Navar 2011; 34: 9-20.
https://doi.org/10.4321/S1137-66272011000100002
4. PEDERSEN AF, OLESEN F, HANSEN RP, ZACHARIAE R, VEDSTED P. Social support, gender and patient delay. Br J Cancer 2011; 104: 1249-1255.
https://doi.org/10.1038/bjc.2011.87
5. BRIGHT K, BARGHASH M, DONACH M, DE LA BARRERA MG, SCHNEIDER RJ, FORMENTI SC. The role of health system factors in delaying final diagnosis and treatment of breast cancer in Mexico City, Mexico. Breast. 2011; 20 (Suppl 2): S54-S59.
https://doi.org/10.1016/j.breast.2011.02.012
6. FERNÁNDEZ E, PORTA M, MALATS N, BELLOC J, GALLÉN M. Symptom to diagnosis interval and survival in cancers of the digestive tract. Dig Dis Sci 2002; 47: 2434-2440.
https://doi.org/10.1023/A:1020535304670
7. RONCORONI L, PIETRA N, VIOLI V, SARLI L, CHOUA O, PERACCHIA A. Delay in the diagnosis and outcome of colorectal cancer: a prospective study. Eur J Surg Oncol 1999; 25: 173-178.
https://doi.org/10.1053/ejso.1998.0622
8. BILIMORIA KY, KO CY, TOMLINSON JS, STEWART AK, TALAMONTI MS, HYNES DL, WINCHESTER DP, BENTREM DJ. Wait times for cancer surgery in the United States: trends and predictors of delays. Ann Surg 2011; 253: 779-785.
https://doi.org/10.1097/SLA.0b013e318211cc0f
9. HANNA TP, KANGOLLE AC. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency. BMC Int Health Hum Rights 2010; 13; 10-24.
https://doi.org/10.1186/1472-698X-10-24
10. RICHARDS MA, WESTCOMBE AM, LOVE SB, LITTLEJOHNS P, RAMIREZ A. Influence of delay on survival in patients with breast cancer: A systematic review. Lancet 1999; 353: 1119-1126.
https://doi.org/10.1016/S0140-6736(99)02143-1
11. MONTGOMER M, MCCRONE SH. Psychological distress associated with the diagnostic phase for suspected breast cancer: systematic review. J Adv Nurs 2010; 66: 2372-2390.
https://doi.org/10.1111/j.1365-2648.2010.05439.x
12. PAICE JA, FERRELL B. The management of cancer pain. CA Cancer J Clin 2011; 61: 157-182.
https://doi.org/10.3322/caac.20112
13. SALOMAA ER, SÄLLINEN S, HIEKKANEN H, LIIPPO K. Delays in the diagnosis and treatment of lung cancer. Chest 2005; 128: 2282-2288.
https://doi.org/10.1378/chest.128.4.2282
14. RICHARDS MA, SMITH P, RAMIREZ AJ, FENTIMAN IS, RUBENS RD. The influence on survival of delay in the presentation and treatment of symptomatic breast cancer. Br J Cancer 1999; 79: 858-864.
https://doi.org/10.1038/sj.bjc.6690137
15. PÉREZ G, PORTA M, BORRELL C, CASAMITJANA M, BONFILL X, BOLIBAR I, FERNÁNDEZ E. Interval from diagnosis to treatment onset for six major cancers in Catalonia, Spain. Cancer Detect Prev 2008; 32: 267-275.
https://doi.org/10.1016/j.cdp.2008.05.006
16. DECRETO 15/2007, de 9 de febrero, del Consell, por el que se establecen mecanismos para agilizar la asistencia sanitaria a procesos oncológicos. DOGV nº 5.449 / 13.02.2007.
17. HANNA TP, KANGOLLE AC. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency. BMC Cancer. 2011; 11: 48. [Epub ahead of print]
https://doi.org/10.1186/1472-698X-10-24
18. Dirección General de Salud Pública. Oncoguía del cáncer colorrectal de la Comunidad Valenciana. Conselleria de Sanitat. Valencia, 2007.
19. Dirección General de Salud Pública. Oncoguía del cáncer de mama de la Comunidad Valenciana. Conselleria de Sanitat. Valencia, 2005.
20. MALY RC, LEAKE B, MOJICA CM, LIU Y, DIAMANT AL, THIND A. What influences diagnostic delay in low-income women with breast cancer? J Womens Health (Larchmt) 2011. [Epub ahead of print].
https://doi.org/10.1089/jwh.2010.2105
21. TRUFELLI DC, MIRANDA VDA C, SANTOS MB, FRAILE NM, PECORONI PG, GONZAGA SDE F et al. Análise do atraso no diagnóstico e tratamento do câncer de mama em um hospital público. Rev Assoc Med Bras 2008; 54: 72-76.
https://doi.org/10.1590/S0104-42302008000100024
22. RAYSON D, CHIASSON D, DEWAR R. Elapsed time from breast cancer detection to first adjuvant therapy in a Canadian province, 1999-2000. CMAJ 2004; 170: 957-961.
https://doi.org/10.1503/cmaj.1020972
23. ARNDT V, STURMER T, STEGMAIER C, ZIEGLER H, BECKER A, BRENNER H. Provider delay among patients with breast cancer in Germany: a population-based study. J Clin Oncol 2003; 21: 1440-1446.
https://doi.org/10.1200/JCO.2003.08.071
24. ESTEVA M, RAMOS M, CABEZA E, LLOBERA J, RUIZ A, PITA S et al. DECCIRE research group. Factors influencing delay in the diagnosis of colorectal cancer: a study protocol. BMC Cancer 2007; 7: 86.
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