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Times from diagnosis to first consult and from first consult to first radiation/chemotherapy were agreed to be important components of the primary interval.
Interval (1), above, was selected as the primary interval of interest for comparison because, of the three intervals, it is the best summary measure of the total time-to-care experience of patients post-diagnosis.
Chart abstractions were used to measure nine time intervals; the primary interval was the date of referral for diagnostic assessment to the date the patient was informed of the diagnosis.
The median (IQR) time for the primary interval was 71 (30 110), 37 (29 49), and 81 (56 100) days for colorectal, lung, and prostate patients, respectively (Kruskal Wallis P=0.0001).
Similar(56)
Older age was statistically significantly associated with longer intervals of both primary care interval of >30 days and diagnostic interval of ≥69 days.
We performed a number of sensitivity analyses investigating the impact of how the primary-care interval, primary-care investigation use and clinical presentation were parameterised (see Appendix Tables for details).
The overall median primary care interval was 7 days (interquartile interval (IQI): 0 30); the median diagnostic interval was 29 days (IQI: 12 69).
The median primary care interval and the diagnostic interval were statistically significantly shorter if the GP suspected cancer or a serious disease (Table 3).
The median primary care interval and the diagnostic intervals were longer among patients with the lowest educational level (Table 3) than among better educated patients.
The relative contribution of each of the two intervals (i.e., the patient or the primary care interval) to the length of the overall pre-referral interval from symptom onset to referral is nonetheless inadequately described for most cancers.
The imputation model included all variables used in the analysis model and, in addition, the primary care interval variable (as the primary care interval is strongly correlated with the proportion of three or more prereferral consultations 16).
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