Effect of Rectal Cancer Treatment Timing Standardization on Patient Outcomes.

Area of Science:

• Oncology
• Health Services Research
• Health Disparities

Background:

• The National Accreditation Program for Rectal Cancer (NAPRC) aims to reduce treatment variations and enhance outcomes.
• A key NAPRC standard is initiating curative-intent treatment within 60 days of initial evaluation.
• This study investigates the impact of timely treatment on rectal cancer outcomes.

Purpose of the Study:

• To evaluate if timely rectal cancer treatment improves oncologic outcomes.
• To identify factors associated with the receipt of timely treatment.
• To explore the influence of socioeconomic factors on treatment timeliness and survival.

Main Methods:

• Analysis of 117,459 stage I-III rectal cancer patients from the National Cancer Database (NCDB), 2004-2020.
• Patients were categorized into timely (<60 days) and delayed (≥60 days) treatment cohorts.
• Survival analysis and logistic regression were used to identify factors associated with timely treatment.

Main Results:

• Timely treatment was significantly associated with improved overall survival (median OS: 153.26 vs. 128.59 months).
• Higher income, stage II/III cancer, and receiving neoadjuvant chemotherapy or chemoradiation first were linked to more timely treatment.
• Patients with higher comorbidity scores (Charlson ≥2) and Black or Hispanic race experienced more delayed treatment.

Conclusions:

• Initiating rectal cancer treatment within 60 days is crucial for improving patient survival.
• Socioeconomic and racial disparities significantly affect treatment timeliness, leading to worse survival outcomes.
• Standardizing care nationally is essential to address these disparities and ensure timely, effective treatment for all rectal cancer patients.