Faster Diagnosis and Treatment for Cancer: Assessing Patient Pathways Using a Panel Regression Analysis of the English National Cancer Registration Data

Abstract

ObjectivesTimely treatment is crucial for patients with cancer, affecting both their experience and outcomes. This study examined events that shorten or extend cancer pathways. MethodsA cohort of breast, lower gastrointestinal, lung, and prostate cancers diagnosed between 2015 and 2016 in England were identified using cancer registration data. This was linked to Hospital Episode Statistic data, Cancer Waiting Times data, and specialized treatment data sets to highlight key events and dates in the pathways of 236 205 patients.Our fixed-effects panel regression included straight-to-test first appointments, multiple tests on the same day, number of multidisciplinary team meetings, appointment cancellations, trust fixed effects, and patient factors, including sex, ethnicity, index of multiple deprivations, age, comorbidities, stage, and route to diagnosis. ResultsPatients with straight-to-test, multiple tests on the same day, and who were discussed in a single multidisciplinary team meeting waited a shorter time for treatment (-5, -4, and -7 days, respectively). Cancelled appointments and attending multiple providers were associated with longer pathways (+11 and +9 days). ConclusionsOur findings highlight specific areas in which redesigning cancer pathways and transfers between hospitals could potentially lead to less waiting time for treatment, and suggest that policies aimed at reducing cancellations, by patients or hospitals, have the potential to improve waiting times.