Primary Care Continuity and Wait Times to Receiving Breast Cancer Chemotherapy: A Population-Based Retrospective Cohort Study Using CanIMPACT Data
- PMID: 34898582
- PMCID: PMC8628668
- DOI: 10.3390/curroncol28060405
Primary Care Continuity and Wait Times to Receiving Breast Cancer Chemotherapy: A Population-Based Retrospective Cohort Study Using CanIMPACT Data
Abstract
(1) Background: Wait times to chemotherapy are associated with morbidity and mortality in breast cancer patients; however, it is unclear how primary care physician (PCP) continuity impacts these wait times, or whether this association is different in immigrants, who experience cancer care inequities. We assessed the association between PCP continuity and the contact-to-chemotherapy interval (wait time from when a patient first presents to healthcare to the first day of receiving breast cancer chemotherapy), with a specific look at the immigrant population. (2) Methods: Population-based, retrospective cohort study of women who were diagnosed with stage I-III breast cancer in Ontario who received surgery and adjuvant chemotherapy. We used quantile regression at the median and 90th percentile to quantify the effect of PCP continuity on the contact-to-chemotherapy interval, performing a separate analysis on the immigrant population. (3) Results: Among 12,781 breast cancer patients, including 1706 immigrants, the median contact-to-chemotherapy interval (126 days) was 3.21 days shorter (95% confidence interval (CI) 0.47-5.96) in symptom-detected patients with low PCP continuity, 10.68 days shorter (95% CI 5.36-16.00) in symptom-detected patients with no baseline PCP visits and 17.43 days longer (95% CI 0.90-34.76) in screen-detected immigrants with low PCP continuity compared to the same groups with high PCP continuity. (4) Conclusions: Higher PCP continuity was not associated with a change in the contact-to-chemotherapy interval for most of our study population, but was associated with a marginally longer interval in our symptom-detected population and a shorter contact-to-chemotherapy interval in screen-detected immigrants. This highlights the importance of PCP continuity among immigrants with positive screening results. Additionally, having no PCP visits at baseline was associated with a shorter contact-to-chemotherapy interval in symptom-detected patients.
Keywords: breast cancer; population health; primary health care; wait times.
Conflict of interest statement
The authors declare no conflict of interest.
Figures
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References
-
- Canadian Cancer Society’s Advisory Committee on Cancer Statistics. [(accessed on 24 June 2021)]. Available online: https://www.canada.ca/en/public-health/services/chronic-diseases/cancer/....
-
- Statistics Canada Table 2: Count and Percentage of Surgically Treated Female Breast Tumours, by American Joint Committee on Cancer Stage at Diagnosis, by Province and Territory, Canada (except Quebec), 2010 to 2012 Combined. [(accessed on 27 July 2021)];2018 Available online: https://www150.statcan.gc.ca/n1/pub/82-003-x/2018008/article/00001/tbl/t....
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