Quality assurance in cancer. Acceptable delays in deciding the therapeutic plan in breast cancer and colorectal cancer

Mira, J, Perez-Jover, V, Ibanez, J, Guilabert, M, Cuevas, D, Salas, D
Background. To determine recommended delays for treatment once there is well-founded clinical suspicion in care processes for breast and colorectal cancer, taking into account resources and the psychological well-being of the patients. Method. A qualitative study among professionals. The study was conducted in two phases. Firstly, during 4 sessions (N=19) we conducted a revision of the care processes of breast cancer and colorectal cancer and fixed desirable times. Secondly, through a modification of the Delphi technique (N=49), the proposed times for each care process were validated. Results. Delphi response rates of 69% and 58% for colorectal and breast processes respectively. The recommended time in the case of non-invasive breast cancer was 5 to 6 weeks. If the cancer was invasive and nuclear medicine was used for sentinel node study or axillary clearance 5 to 7 weeks were recommended. In the case of cancer of the colon and rectum 7 to 13 weeks were considered necessary. Conclusions. Breast cancer treatment should be started before six weeks. In colorectal cancer up to three months could be required. An interdisciplinary review of care processes relying on professionals is useful for establishing realistic quality standards.
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