Observational studyPloS one2019
Time to initial cancer treatment in the United States and association with survival over time: An observational study.
Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 187 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
187 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- The effect of time before diagnosis and treatment on colorectal cancer outcomes: systematic review and dose-response meta-analysis.British journal of cancer · 2023Pooled it
- The efficacy of albumin-globulin ratio to predict prognosis in cancer patients.International journal of clinical oncology · 2023Pooled it
- Long-term Mortality in Individuals Diagnosed With Cancer During Pregnancy or Postpartum.JAMA oncology · 2023Pooled it
- Association between time-to-treatment and outcomes in non-small cell lung cancer: a systematic review.Thorax · 2022Pooled it
- Conflicting Guidelines: A Systematic Review on the Proper Interval for Colorectal Cancer Treatment.World journal of surgery · 2021Pooled it
- Guideline
- AI-based chest X-ray prioritization in the lung cancer diagnostic pathway: the LungIMPACT randomized controlled trial.Nature medicine · 2026Trial
- Effect of an Antiracism Intervention on Racial Disparities in Time to Lung Cancer Surgery.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Trial
- Article
- Delays in Malignant Neck Mass Diagnosis: Missed Opportunities in Clinical Decision-Making.The Permanente journal · 2026Article
- Delayed treatment initiation is associated with worse survival in screening-detected patients with upper gastrointestinal cancer in rural China: a 10-year cohort study.Journal of global health · 2026Article
- An assessment of time toxicity in patients receiving [177Lu]Lu-PSMA-617 for metastatic castration-resistant prostate cancer.The oncologist · 2026Article
- Combined Association of Time to Treatment, Guideline Concordance, and Neighborhood Vulnerability with Localized Colon Cancer, Non-small-cell Lung Cancer, and Pancreatic Cancer Survival.Annals of surgical oncology · 2026Article
- Increasing time-to-treatment for resectable non-small cell lung cancer: Predictors and survival impact.JTCVS open · 2026Article
- Piloting a specialty pharmacy turnaround time quality measure: Findings and lessons learned.Journal of managed care & specialty pharmacy · 2026Article
- Temporal trends and sociodemographic determinants of time to nephrectomy in localized renal cell cancer.International urology and nephrology · 2026Article
- Early Adherence to Immunomodulators in Multiple Myeloma: Retrospective Observations from a Safety-Net Hospital.Current oncology (Toronto, Ont.) · 2026Article
- Marital Status Is Associated With Treatment Attainment in Pancreatic Adenocarcinoma.Journal of surgical oncology · 2026Article
- Characteristics and Outcomes of Patients With Malignancies Prior to Colorectal Cancer: A Propensity Score Matched Analysis.Journal of gastrointestinal cancer · 2026Article
- Treatment Timeliness in Extensive-Stage SCLC and Impact on Survival: A Registry-Based Observational Study.JTO clinical and research reports · 2026Article
127 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelays in time to treatment initiation (TTI) for new cancer diagnoses cause patient distress and may adversely affect outcomes. We investigated trends in TTI for common solid tumors treated with curative intent, determinants of increased TTI and association with overall survival. METHODS AND
findingsWe utilized prospective data from the National Cancer Database for newly diagnosed United States patients with early-stage breast, prostate, lung, colorectal, renal and pancreas cancers from 2004-13. TTI was defined as days from diagnosis to first treatment (surgery, systemic or radiation therapy). Negative binomial regression and Cox proportional hazard models were used for analysis. The study population of 3,672,561 patients included breast (N = 1,368,024), prostate (N = 944,246), colorectal (N = 662,094), non-small cell lung (N = 363,863), renal (N = 262,915) and pancreas (N = 71,419) cancers. Median TTI increased from 21 to 29 days (P<0.001). Aside from year of diagnosis, determinants of increased TTI included care at academic center, race, education, prior history of cancer, transfer of facility, comorbidities and age. Increased TTI was associated with worsened survival for stages I and II breast, lung, renal and pancreas cancers, and stage I colorectal cancers, with hazard ratios ranging from 1.005 (95% confidence intervals [CI] 1.002-1.008) to 1.030 (95% CI 1.025-1.035) per week of increased TTI.
conclusionsTTI has lengthened significantly and is associated with absolute increased risk of mortality ranging from 1.2-3.2% per week in curative settings such as early-stage breast, lung, renal and pancreas cancers. Studies of interventions to ease navigation and reduce barriers are warranted to diminish potential harm to patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.