The waiting time paradox: population based retrospective study of treatment delay and survival of women with endometrial cancer in Scotland. (Papers).

Delay in the delivery of treatment for gynaecological cancers has been previously investigated. (1 2) In some cases, the delay reflects the illness behaviour of women; in others, it was inherent in the system for delivering health care. Few studies have linked delay in treatment with survival, although a study from Israel found that survival from endometrial cancer was not affected by a delay in treatment of four months). (3)

We investigated links between delays in treatment and survival, using a recently completed audit of endometrial cancer treatment in Scotland.

Methods and results

We collected data from the case notes of all women resident in Scotland who were diagnosed between 1 January 1996 and 31 December 1997 as having endometrial carcinoma. Of 781 cases, we found case notes for 714, and, out of these, we analysed the 703 cases that involved operative treatment.

We calculated time intervals from the dates of general practitioner referral letters, clinic appointments, …