Impact of Age and Diagnosis on Waiting Times Between Important Healthcare Events Among Children 0 to 19 Years Cared for in Pediatric Units

TLDR

Waiting times to diagnosis and treatment in Canadian pediatric oncology centers are critical for timely cancer care. The study aimed to describe and compare waiting times to diagnosis and treatment among children and adolescents in Canadian pediatric oncology centers and assess the effects of age, sex, and diagnosis. The authors analyzed 2365 children and 375 adolescents diagnosed with cancer between 1995 and 2000, using the Treatment and Outcome Surveillance system, and compared waiting times with χ², Fisher exact, and Wilcoxon tests. Median waiting times from first assessment to definitive diagnosis and to first therapeutic event were both 2 days, with variation by age and diagnosis that was not clinically significant and disappeared when stratified by diagnosis.

Abstract

Background The objectives were to describe and compare waiting times to diagnosis and treatment of children and adolescents who accessed pediatric oncology centers in Canada for healthcare, and to assess the effects and relative contributions of age, sex, and diagnosis to waiting times. Methods Waiting times were assessed for 2365 children (0 to 14 y) and 375 adolescents (15 to 19 y) diagnosed with cancer between 1995 and 2000 inclusive and followed by the Treatment and Outcome Surveillance system of the Canadian Children's Cancer Surveillance and Control Program. Differences were assessed using the χ2 test, Fisher exact test, and Wilcoxon test statistic. Results Median waiting times between first assessment by treating oncologist or surgeon and definitive diagnostic procedure, and the subsequent interval to first therapeutic event, were 2 days each. Significant variation existed in both periods when stratified by age and diagnosis but not sex. The most significant differences between age groups were eliminated when stratified by diagnosis. Interpretation This analysis suggests that once they enter the healthcare system, children and adolescents treated in pediatric centers in Canada experience short waiting times to key diagnostic and treatment events. Differences in wait times between the 2 age groups are not clinically significant and can be attributed to the differences in the types of cancer experienced by adolescents compared with children.