Wait times for cancer treatment in the U.S. have increased by nearly two weeks over the last decade, according to a study published in JAMA Surgery. The researchers, from the University of California, Los Angeles and Massachusetts General Hospital, looked at data from over two million patients diagnosed between January 2012 and December 2023.
The study focused on adults facing early to locally advanced stages of six common cancers: breast, colon, lung, pancreatic, stomach, and esophageal. It recorded the period from diagnosis to the first treatment, which could either be surgery or pre-surgical therapy aimed at shrinking tumors.
Across all cancer types studied, the median wait times grew by more than 10 days during this time frame, irrespective of whether surgery happened first or was part of a later treatment plan.
The longest delays were noted in stomach cancer, where waiting times jumped from 35 days to 49 days, and lung cancer, which rose from 41 days to 53 days. Moreover, breast cancer wait times increased from 34 to 45 days, and colon cancer delays extended from 20 to 31 days. For pancreatic cancer, wait times went from 23 to 32 days, and esophageal cancer saw delays grow from 38 to 48 days. The study also highlighted that a rising number of patients experienced waits of 60 days or more before starting treatment.
Dr. Marc Siegel, a senior medical analyst, expressed concerns about these findings, stating, “This is part of our healthcare system that needs fixing immediately.” He noted that these delays were even present in high-volume academic medical centers, emphasizing that waiting times for essential cancer surgeries for non-metastatic diseases have been on the rise since 2012.
After adjusting for factors such as age and health status, the research revealed disparities in delays. Black patients, those on Medicaid, individuals from lower-income areas, and patients traveling longer distances for care faced longer wait times. Furthermore, the West region reported more significant delays, and the use of robotic surgery was associated with even longer waiting periods for non-breast cancers.
Researchers pointed out that previous studies have linked delays in surgical treatment to higher mortality rates and poorer long-term survival outcomes.
In an accompanying commentary, Dr. Lia D. Delaney and Dr. Sherry M. Wren from Stanford School of Medicine discussed the increasing sophistication of cancer care over the last two decades. However, they cautioned that as cancer care becomes more specialized, there is a risk that quality improvements may unintentionally hinder timely treatment, unless enhancements in capacity and coordination keep pace.
The authors also acknowledged certain limitations of the study, noting that because it relied on retrospective data from the National Cancer Database, it couldn’t pinpoint the specific causes of treatment delays, such as scheduling conflicts or individual patient preferences. Additionally, the database didn’t provide information on when patients first noticed symptoms or sought medical advice before their diagnosis.
