EP625 - Rectal cancer wait times: A survey of provider wait time expectations among patients with locally advanced rectal cancer

ePoster Presenter(s)

• 

  Mariana Tumminello, MD

  Resident Physician
  Medstar Georgetown Washington Hospital Center
  MedStar Georgetown/Washington Hospital Center
  Washington, DC, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• 

  Jacob M. Broome, MD

  General Surgery Resident
  MedStar Georgetown-Washington Hospital Center
  Georgetown Washington Hospital Center
  Washington, DC, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• 

  Jacob Neary, MS, MD

  Fellow
  MedStar Washington Hospital Center
  Medstar Washington Hospital Center-Georgetown University Hospital
  Washington, DC, United States

  Disclosure information not submitted.
• SG

  Shadin Ghabra, MD

  Resident
  Medstar Georgetown University Hospital
  Medstar Georgetown University Hospital
  Arlington, VA, United States

  Disclosure information not submitted.
• AH

  Alana Hagley, n/a

  PGY3 Surgery Resident
  Medstar Georgetown/Washington Hospital Center
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• ZS

  Zhifei (Jeff) Sun, MD

  Assistant Professor of Surgery
  MedStar Health
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• SB

  Sara Berkey, MD

  Assistant Professor of Surgery
  MedStar Health
  Washington, District of Columbia, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• 

  Preetha Ali, MD

  Assistant Professor of Surgery
  MedStar Health
  Washington, District of Columbia, United States

  Disclosure information not submitted.
• AF

  Anne Fabrizio, MD

  Colon and Rectal Surgeon
  Medstar Georgetown University Hospital
  Washington, District of Columbia, United States

  Disclosure information not submitted.

Senior Author(s)

• BB

  Brian Bello, MD

  Regional Chief of Colorectal Surgery
  MedStar Health

  Disclosure information not submitted.

Purpose/Background: The National Accreditation Program for Rectal Cancer (NAPRC) recommends that at least 80% of rectal cancer patients with stage II or III disease should initiate definitive treatment within 60 days of diagnosis. Recent large database studies have shown that there is no difference in progression-free survival or all-cause mortality past 60 day initiation timeline. In our study, we aim to survey stakeholders within the rectal cancer journey to better understand provider expectations of patient wait times from diagnosis to start of neoadjuvant treatment.

Methods/Interventions: A survey was conducted among healthcare providers at multiple academic and non-academic institutions to better understand provider expectations of rectal cancer treatment wait times in patients with locally advanced (Stage II or III) disease. Providers surveyed included Colon and Rectal Surgeons (CRS), Gastroenterologists (GI), Radiologists, Medical/Radiation Oncologists (MO/RO) and Primary Care Physicians (PCP). Providers were queried on their expectations for wait times for patients undergoing management of Stage II/III rectal cancer (i.e. diagnosis to first visit with specialists, diagnosis to MRI imaging, diagnosis to staging CT, first MO visit to start of neoadjuvant treatment). Date of diagnosis was defined as pathologic reporting of rectal cancer.

Results/Outcomes: 30 providers completed the survey. Overall, the majority of providers were male (60%), aged between 30-49 (73%), and had been in practice 5-10 years (30%). 50% of providers were CRS, with the next most common providers being GI (20%) and MO/RO (16.7%). 63.3% of providers practiced in an academic setting. Median expected wait times were evaluated (Figure 1). The median expected wait times from the perspective of providers from diagnosis to staging CT was 7 days (IQR 7-14), diagnosis to pelvic MRI was 7 day (IQR 7-14), diagnosis to first CRS visit was 10 days (IQR 7-14), diagnosis to first MO visit was 10 days (IQR 7-14), diagnosis to first RO visit was 12 days (IQR 7-14), and first MO visit to start of neoadjuvant treatment was 14 days (10-21).

Conclusion/Discussion: While NAPRC recommends initiation of neoadjuvant therapy within 60 days, healthcare providers involved in rectal cancer treatment expect patients to progress through their care timeline faster than 60 days. This study may serve as a reference for current provider expectations of patients involved in rectal cancer care.

Rectal Cancer Wait Times
Figure 1. Median expected wait times for patients diagnosed with rectal cancer from the perspective of healthcare providers.