Wait times between a cancer diagnosis and the start of treatment have grown by nearly two weeks over the past decade in the United States, according to a study published in JAMA Surgery. Researchers from the University of California, Los Angeles, and Massachusetts General Hospital analyzed national data from more than two million patients diagnosed between January 2012 and December 2023.
The study tracked adults with early to locally advanced stages of six common cancers—breast, colon, lung, pancreatic, stomach, and esophageal—who received surgery as part of their initial care. Researchers measured wait times from the day of diagnosis to the first treatment, which could be surgery or pre-surgical therapy intended to shrink a tumor. Across all six cancer types, median wait times increased by more than 10 days over the study period, irrespective of whether surgery preceded other treatments or followed them.
The longest increases were observed in stomach cancer, where wait times rose from 35 days to 49 days, and lung cancer, which increased from 41 days to 53 days. Breast cancer wait times grew from 34 to 45 days, while colon cancer delays increased from 20 to 31 days. Pancreatic cancer waits climbed from 23 to 32 days, and esophageal cancer delays grew from 38 to 48 days. The researchers also noted that a growing proportion of patients waited 60 days or longer to begin treatment.
"This is part of our healthcare system that needs fixing immediately," said Dr. Marc Siegel, a senior medical analyst for Fox News, who was not involved in the study. He noted that these delays were evident even at high-volume academic medical centers, stating, "The waiting times for basic cancer operations in non-metastatic diseases is high and increasing since 2012."
After adjusting for factors such as age and underlying health conditions, researchers found that the delays disproportionately affected certain groups. Longer wait times were observed for Black patients, individuals on Medicaid, people residing in lower-income areas, patients traveling greater distances for care, and those treated at academic medical centers or high-volume hospitals. The Western region of the U.S. experienced longer delays compared to other regions. For non-breast cancers, the use of robotic surgery was associated with longer wait times.
The study authors cautioned that previous medical research has linked delays in surgical treatment to higher mortality rates and worse long-term survival. In accompanying commentary, Drs. Lia D. Delaney and Sherry M. Wren of the Stanford School of Medicine emphasized that while cancer care has become more sophisticated, "as cancer care continues to regionalize, efforts to improve quality may inadvertently create barriers to timely treatment unless capacity and coordination evolve in parallel."
The study authors acknowledged certain limitations, including the reliance on retrospective data from the National Cancer Database. This prevented them from identifying the precise reasons for individual treatment delays, such as scheduling conflicts, logistical challenges, or patient preferences. The database also did not contain information on when patients first experienced symptoms or sought medical advice prior to their diagnosis.