Have actual waiting times been reduced by introducing the DILO reform for cancer patients in Poland?

Abstract

Introduction. Relative 5-year cancer survival rates in Poland are around 10% lower than the average of the whole EU. One of the likely factors for poorer treatment outcomes in Poland may be the long times between when cancer is suspected to starting treatment. This study has thus aimed to determine whether the introduced oncology reforms have succeeded in reducing such times.

Materials and methods. The study survey was undertaken at 6 oncological centres on patient subjects before (n = 1373) and after (n = 431) the oncological reform (DILO) had been introduced. Data was obtained from an in-house devised questionnaire together with patient interview and their medical history. The following waiting times were estimated: A) from suspicion of cancer, (date of first doctor visit due to appearance of symptoms, screening/follow-up or prevention), to diagnosis (date of histopathological confirmation), B) from suspicion of cancer to the start of treatment and C) from diagnosis to starting treatment before and after the DILO reform had been introduced.

Results. The median waiting time between suspicion of cancer and treatment was 11 weeks before the DILO reform but was not significantly shortened after its introduction; the reduction being barely 3 days. This waiting time was however increased by 8 days in those patients without DILO cards. Before the DILO reform, the median time from diagnosis was 5.9 weeks, but was reduced by 8 days in patients bearing the DILO card and indeed increased in those without the DILO card by over 2 weeks.

Conclusions. Cancer treatment waiting times in Poland is still somewhat long (over 9 weeks in most cases). Introducing the oncological reform has not significantly impacted on shortening the waiting times in cancer patients for receiving oncological treatment.