Victoria proven as world-leader in timely care for bowel cancer patients

Wednesday 28 November, 2018

Victoria is a world-leader when it comes to bowel cancer diagnosis and treatment times according to an international study released today that compares intervals from patients first noticing a symptom to diagnosis and starting treatment.

Published in BMJ Open today, Victoria was found to have the second-shortest median period of 90 days between a patient first noticing their symptom and starting treatment, second only to Denmark at 77 days.

The time taken from a patient presenting to a health care professional until the time they receive a diagnosis of bowel cancer varies widely internationally, with the shortest median intervals in Denmark and Victoria at 27 and 28 days respectively; and the longest in Manitoba Canada at 76 days.

The research, part of the International Cancer Benchmarking Partnership (ICBP), is the first study of this kind on this scale, and includes 2,866 bowel cancer patients, 1,774 GPs and 938 cancer treatment specialists.

The study was conducted in ten jurisdictions across the six countries: Australia (Victoria), Canada (Manitoba and Ontario), Denmark, Norway, Sweden and the UK (England, Northern Ireland, Wales, and Scotland).

Professor Vicki White, from Cancer Council Victoria’s Behavioural Science Division and Deakin University said the aim of the study was to examine whether time to diagnosis and treatment differs between countries.

“By having access to this type of important information, we can learn from each other what is working well, and where care pathways need to be improved.”

Professor White said it is encouraging to see Denmark and Victoria faring so well in the study, as in both countries work has been done to implement care pathways that outline best practice.

“Denmark’s leadership in this area has seen great results since 2009 when they introduced significant reforms to improve diagnostic access for GPs and shorten the interval from presentation to diagnosis.

“Victoria is also currently implementing Optimal Care Pathways, a guide for clinicians and patients which identifies critical points along the cancer diagnosis and care pathways and the recommended care at each point. This study shows that while our health system can facilitate fast movement of patients through their cancer journey, unfortunately some patients are still waiting too long.  We hope that as the Optimal Care Pathways get incorporated into usual care by clinicians, we can further reduce the time it takes to diagnose and treat Victorians for bowel cancer” Professor White said.

However, the outcomes were not so positive in all jurisdictions, with the longest median interval from first symptom to start of treatment experienced by patients in Northern Ireland (138 days), England (145 days), Manitoba (154 days) and Wales (168 days).

The findings also show that 10% of people had a total interval of 11 to 12 months or more from noticing symptoms to starting treatment in most jurisdictions, including Victoria, with Denmark the only exception.

This study follows research published this year by Cancer Council Victoria that examined whether delayed pathways to diagnosis and treatment contribute to survival disparities between rural and urban bowel cancer patients in Victoria.

Lead researcher and Senior Research Officer at Cancer Council Victoria’s Behavioural Science Division, Dr Rebecca Bergin, said people living in a rural area were found to have longer intervals, with most disparities in the time from first presentation to a health care professional to diagnosis.

“My research found that in Victoria the median time from first symptom to treatment was 18 days longer for rural compared with urban patients, with most differences in the diagnostic interval. This type of information is important as it allows us to identify where changes in policy or pathways should be targeted to reduce cancer outcome disparities in Victoria.” Dr Bergin said.

The Optimal Care Pathways aim to reduce such differences, and a new study is underway to determine whether the timeliness of care for Victorians with bowel cancer is improving with the introduction of these pathways. This National Health and Medical Research Council (NHMRC) funded study, conducted by Cancer Council Victoria in partnership with the Victorian Government Department of Health and Human Services, will use the ICBP study as a baseline to examine improvements in cancer care. 

Read the full article here: https://bmjopen.bmj.com/content/8/11/e023870

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The International Cancer Benchmarking Partnership is supported by the Victorian Government.

About Cancer Council Victoria

Cancer Council Victoria is a non-profit organisation and has been leading the fight against all cancers for 82 years. We focus on cancer research, patient support, cancer prevention and advocacy. Please visit www.cancervic.org.au for further information.

Find out more about Optimal Care Pathways at: www.cancervic.org.au/for-health-professionals/optimal-care-pathways 

Weller et al, Diagnostic routes and time intervals for colorectal cancer in ten international jurisdictions; findings from a cross-sectional study from the International Cancer Benchmarking Partnership.