Abstract
INTRODUCTION: The aim of this study was to determine and quantify the mechanisms responsible for the delays in bladder cancer diagnosis and initial treatment. MATERIAL AND METHODS: Patients referred to two academic hospitals in Poland with a primary bladder tumor were prospectively identified and structurally interviewed. For all patients, time intervals between symptom onset, diagnostic and therapeutic interventions were assessed. RESULTS: A total of 144 patients diagnosed with bladder cancer were included in the analysis. The median time from symptom onset to treatment was 112 days. This comprised of the following median waiting times: 1) patient waiting time of 13 days, 2) assessment waiting time of 14 days and 3) treatment waiting time of 42 days. In the multivariate analysis, large city residence (OR 0.2, 95% CI 0.1-0.6) and comorbidity (OR 0.3, 95% CI 0.1-0.8) reduced the risk of delay, whereas medium-sized city residence (OR 1.4, 95% CI 0.4-5.1) and general practitioner as the first medical professional contact (OR 5.3, 95% CI 0.6-50.0) increased the risk of delay. CONCLUSIONS: Diagnostic and treatment waiting times for bladder cancer in Poland are unsatisfactory. Potential solutions for shortening these delays include healthcare policy changes such as utilization of the oncological priority programs, primary care education and public health campaigns.