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Ontario Cancer Facts

Women with breast cancer are being appropriately assigned surgical wait times

Feb 2018

Highlights

 

  • This analysis indicates that breast cancer cases diagnosed in 2011 were appropriately prioritized for surgery under the Ontario wait time strategy’s system.
  • There was no significant difference in survival among women with breast cancer based on how long they waited for surgery after being prioritized.
  • The majority of women with breast cancer received surgical treatment within the recommended time.

 

A recent analysis shows that under the Ontario wait time strategy’s prioritization system, breast cancer cases diagnosed in 2011 were appropriately prioritized and wait times were effectively managed.

Under the wait time prioritization system, once the decision to treat a cancer with surgery is made, the case is assigned a priority level. The priority level is associated with a recommended maximum wait time for surgery and is based on the case’s urgency, which is determined by someone’s health and the characteristics of their cancer. When cases were prioritized this way, there was no significant difference in five-year observed survival in women who waited less than 15 days and women who waited more than 84 days. This finding held for all stages of diagnosis.

There are 4 priority levels:

  • level 1 (surgery recommended within 24 hours)
  • level 2 (highly aggressive malignancies, surgery recommended within 14 days)
  • level 3 (invasive malignancies that do not meet the criteria for priority level 2 or 4, surgery recommended within 28 days)
  • level 4 (slow growing malignancies, surgery recommended within 84 days)

Sources: Ontario Cancer Registry (March 2017), CCO; Wait Time Information System (March 2017), CCO

Notes:
There was insufficient data to produce estimates for women diagnosed at stages II, III, or IV who had a wait time of 84 days or longer.
*Due to incomplete data, cases recommended for surgery within 24 hours (priority level 1) were excluded from this analysis.

Five-year survival, by wait time to surgery* and stage at diagnosis, breast cancer, Ontario, 2011
Stage Wait time ≤14 days Estimate Wait time ≤14 days (95% LCL) Wait time ≤14 days (95% UCL) Wait time 15 to 28 days Estimate Wait time 15 to 28 days (95% LCL) Wait time 15 to 28 days (95% UCL) Wait time 29 to 84 days Estimate Wait time 29 to 84 days (95% LCL) Wait time 29 to 84 days (95% UCL) Wait time >84 days Estimate Wait time >84 days (95% LCL) Wait time >84 days (95% UCL)
All stages 86.3 85.4 87.1 86.1 85.2 86.9 84.7 83.4 86.1 84.5 70.4 92.3
Stage I 94.3 93.3 95.1 93.3 92.3 94.2 93.7 92.2 95.1 95.3 71.3 99.3
Stage II 86.1 84.6 87.5 84.6 82.9 86.1 83.7 81.1 85.9 ** ** **
Stage III 68.9 65.7 71.8 69.8 66.3 73.0 64.8 59.8 69.4 ** ** **
Stage IV 18.6 10.8 28.1 28.3 19.2 38.0 34.9 20.7 49.4 ** ** **

Sources: Ontario Cancer Registry (March 2017), CCO; Wait Time Information System (March 2017), CCO

Notes:
*Due to incomplete data, cases recommended for surgery within 24 hours (priority level 1) were excluded from this analysis.
**Insufficient data to produce estimates.
95% LCL: 95% Lower Confidence Limit.
95% UCL: 95% Upper Confidence Limit.

Wait time in this analysis refers to the time between the decision to treat a cancer with surgery and the first therapeutic surgery performed after diagnosis. The majority of women with breast cancer received surgery within the recommended wait time.

The median wait time for women with breast cancer was 16 days, regardless of the stage at diagnosis. Younger women tended to have shorter wait times, with women under age 40 having a median wait time of 14 days. Women age 80 and older had a median wait time of 18 days. The proportion of women treated within the recommended time increased as urgency decreased:

  • in priority level 2, 72.1% received surgical treatment within the recommended 14 days;
  • in priority level 3, 87.1% received surgery within the recommended 28 days;
  • in priority level 4, 98.9% received surgery within the recommended 84 days.

While some wait for treatment is inevitable, a delay in cancer surgery may reduce the chances of successful treatment because cancer may grow and spread to other parts of the body over time. Surgery is one of the most common types of cancer treatment and approximately 80% of people with cancer will have surgery at some point.

More information on this topic, including analyses of different cancer types, can be found in Ontario Cancer Statistics 2018. This report describes the changing burden of cancer in Ontario’s population, and provides current and historical cancer statistics.