Introduction:

The effects of timeliness in the receipt of treatment following cancer diagnosis on both oncologic outcomes as well as the overall patient experiences are emerging areas of research, which has led to some conflicting results. To explore the impact of timeliness in treatment following a cancer diagnosis, we utilized the Surveillance, Epidemiology, and End Results and Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) linked database to understand the relationship between time-to-treatment and the patient experience ratings among cancer survivors.

Methods:

Using the SEER Patient Entitlement and Diagnosis Summary File, records of patients diagnosed with prostate, bladder, colorectal, lung, or breast cancer between years 2001 and 2013, received treatment within 6 months of diagnosis, and completed a CAHPS survey within 6-18 months of diagnosis were analyzed. Patient experience was measured by global rating scores (on a 0-10 scale) and composite measure scores (on a 0-100 scale) included in the CAHPS survey. Univariable logistic regression analysis was performed to evaluate the associations of global ratings and composite measures with time-to-treatment. A series of multivariable logistic regression analyses were performed in a sequential manner to evaluate the associations of global ratings and composite measures with time-to-treatment, controlling for 1) socioeconomic status (SES), 2) SES and cancer site. Finally, multivariable logistic regression analysis performed evaluated the associations of global ratings with time-to-treatment controlling for SES, cancer site, and composite measures (one at a time).

Results:

A total of 1,586 patients were included, a majority of which had either prostate cancer (37.8%) or breast cancer (31.6%). Univariable analysis identified a weak negative relationship between time-to-treatment and global ratings, while no relationship was identified between time-to-treatment and composite measures. On multivariable analysis, the relationships identified by univariable analysis were similar when controlling for SES and weakened when controlling for SES plus cancer site. Multivariable analysis controlling for SES, cancer site, plus composite measures identified a negative relationship between doctor communication and all global ratings, whereas no relationships was identified between time-to-treatment and global ratings in this model.

Conclusion:

Given these findings, it appears that doctor communication has a greater impact on the patient experience than time-to-treatment. Further exploration is needed to better understand the relationship between time-to-treatment and the patient experience and how components of the patient experience can influence one another.

Funding: N/A