574 Background: The current standard for resected stage 3 colon cancer after surgical resection is adjuvant 5FU-based chemotherapy. In trials, AC is mandated within 8 weeks after surgery, but outside the trial setting, up to 19% of patients do not receive treatment within 8 weeks. A recent meta-analysis confirms that AC started more than 8 weeks after surgery results in significantly decreased overall survival. Our objective was to ascertain logistical and patient factors associated with delayed AC delivery (defined as >56 days from surgery) in referred patients with resected stage 3 colon cancer. Methods: A population-based cohort of patients diagnosed with stage 3 colon cancer between January 2008 to December 2009 referred to the BCCA and treated with at least one cycle of AC were identified. Patient characteristics, and time intervals between surgery, referral, medical oncology consultation (MOC) and AC were assessed. Differences in patient characteristics and time intervals between patients were assessed using the Chi-square and Wilcoxon Rank-sum tests. Results: Median time from surgery to AC was 58 days with 54% of patients receiving AC beyond 56 days. Temporal differences were identified in all intervals between the between the timely and delayed groups (see table 1). Referral was most commonly initiated after hospital discharge. The only patient factors associated with delayed initiation included poorer ECOG status and being treated at the most urban centre within BCCA. Age, gender, comorbidity index, T stage and tumour location were not different between the groups. Conclusions: 54% of patients with stage 3 colon cancer had a delayed AC initiation. Process related delays at each step of the referral process need to be addressed including timely referral, MOC triage and addressing chemotherapy waitlists. [Table: see text]