Open Access

ARTICLE

Surgical wait times for patients with urological cancers: a survey of Canadian surgeons

Neil Fleshner¹, George Dranitsaris², Antonio Finelli¹, John Tsihlias¹, David Bell³, Martin Gleave⁴

1 University of Toronto, Princess Margaret Hospital, Toronto, Ontario, Canada
2 Outcomes Research Consultant, Toronto, Ontario, Canada
3 Dalhousie University, Halifax, Nova Scotia, Canada
4 University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada
Address correspondence to Dr. Neil Fleshner, Department of Surgical Oncology, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2M9 Canada

Canadian Journal of Urology 2006, 13(Suppl.3), 3-13.

Abstract

Background: The wait times for urological cancer surgeries in Canada have increased over the past 2 decades. This is of concern to patients, physicians and other key stakeholders because there is evidence that delaying surgery beyond a recommended threshold could have a negative impact on clinical outcomes. To address these trends, a Canadian surgical wait times (SWAT) initiative has been undertaken to develop a consensus document and make recommendations on appropriate wait times. As a first step, the SWAT steering committee determined that current wait times estimates were required for the four key disease sites: prostate, bladder, kidney and testes. To obtain such data, a survey of Canadian urological surgeons was undertaken.

Methods: A structured electronic mailing strategy was adopted as recommended by Dillman (1978). Standardized data collection forms were sent to members of the Canadian Urological Association (CUA) and attendees to the 2005 CUA meeting. Survey items consisted of respondent demographic data, information on surgical wait times for the four key disease sites and potential barriers to timely cancer surgery.

Results: One hundred and five urological surgeons responded to the survey. There was considerable variation in wait times between and within the four disease sites, with bladder and kidney cancer surgeries displaying the widest range. Operating room availability and staging tests were identified as the most significant barriers to efficient cancer surgery.

Conclusions: The wide variation in wait times identified in this study suggests that the overall time to treatment from referral is beyond the duration considered by many experts and by the Canadian Society of Surgical Oncology to be acceptable. These issues need to be addressed through a partnership between the key stakeholders in order to reduce the potentially negative impact on clinical outcomes and patient quality of life.

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