Factors associated with diagnostic and treatment intervals for prostate cancer in Queensland, Australia: A large cohort study

Objective: To examine the relation between socio-demographic and clinical factors, and time from consultation to diagnosis and treatment for men with prostate cancer. Methods: Men diagnosed with prostate cancer (n = 1,064, response rate = 82%) were recruited through participating urologists and hospital outpatient clinics in Queensland, Australia, and completed telephone interviews and self-administered questionnaires. Outcome measures were the diagnostic interval (initial consultation to definitive diagnosis) and treatment interval (definitive diagnosis to start of treatment). Results: Median time to diagnosis was 73 days (IQR = 41-144) and median treatment interval was 65 days (IQR = 36-107). After adjustment, men were more likely to wait more than 70 days for their definitive diagnosis when they initially presented with symptoms (compared with a general checkup) or did not have private health insurance. For treatment interval, men without private health insurance or who were treated with radiotherapy alone weremore likely to wait more than 70 days. Treatment intervals were shorter when men received androgen deprivation therapy combined with radiotherapy. Conclusions: Differences in waiting times for diagnosis and treatment related to access to private hospital care suggest that there are inequities in health-care service provision that are system based