THURSDAY, Nov. 5, 2020 — A four-week delay in cancer treatment is associated with increased mortality, according to a review and meta-analysis published online Nov. 4 in The BMJ.
Timothy P. Hanna, Ph.D., from the Cancer Research Institute at Queen’s University in Kingston, Ontario, Canada, and colleagues conducted a systematic review and meta-analysis to quantify the association between cancer treatment delay and mortality for each four-week increment. Data were included from 34 studies for 17 indications with 1,272,681 patients.
The researchers found that for five of the radiotherapy indications or for cervical cancer surgery, no high-validity data were found. For 13 of the 17 indications, the association between delay and increased mortality was significant. Surgery findings were consistent, with a mortality risk of 1.06 to 1.08 for each four-week delay. Estimates varied for systemic treatment (hazard ratio range, 1.01 to 1.28). The hazard ratios were 1.09 (95 percent confidence interval, 1.05 to 1.14) for radical radiotherapy for head and neck cancer; 0.98 (95 percent confidence interval, 0.88 to 1.09) for adjuvant radiotherapy after breast-conserving surgery; and 1.23 (95 percent confidence interval, 1.00 to 1.50) for adjuvant radiotherapy for cervical cancer.
“In light of these results, policies focused on minimizing system level delays in cancer treatment initiation could improve population level survival outcomes,” the authors write.
One author disclosed financial ties to Roche.
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