Benchmarking Cervical Cancer Care Pathways—Measuring Timelines and Identifying Factors Associated With Delay for Women Undergoing Definitive Radiotherapy in New South Wales, Australia

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Abstract
Background: Diagnosis and management of cervical cancer require multiple investigations and specialist reviews, with delays leading to increased mortality and morbidity. Australia's Optimal Care Pathways (OCPs) recommends that patients with suspected diagnosis of cervical cancer should have their diagnostic processes completed within certain timeframes. Despite these guidelines, there is currently no benchmarking of cervical cancer timelines. Aims: This study aims to benchmark cervical cancer care and identify factors associated with delay. Materials and Methods: Patients who underwent radiotherapy for Stage I‐III cervical cancer between 2015 and 2024 at a major tertiary hospital in New South Wales (NSW) were included in the study. This hospital provides centralised gynae‐oncology care for all women in three NSW local health districts. Patients were stratified based on age, stage of disease, level of rurality and level of socioeconomic advantage/disadvantage. Each step of the diagnostic timeline was benchmarked against the OCPs. Univariate and multivariate logistic regression were performed to detect factors associated with delays. Results: The study cohort comprised 155 patients. Under 60% of women were managed in‐line with the OCPs recommended timelines. 86% ( n = 19/22) of women from the least disadvantaged socio‐economic tertile saw a gynae‐oncology specialist within the recommended timeframe compared to 47% (36/76) from the most disadvantaged socio‐economic tertile (OR: 6.24, CI: 1.60–24.27, p = 0.008). Conclusions: Recommended diagnostic timelines were not met in a significant proportion of women. Women from the greatest levels of socioeconomic disadvantage were more likely to face delays. Benchmarking processes need to be implemented in cancer care, to ensure equity in outcomes/processes for all patients.

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