Background
Endometrial cancer (EC) is the fifth most commonly diagnosed cancer amongst women in Australia, and the eighth most common cause of cancer mortality. In Western NSW, there are three regional cancer services, but no networked referral gynaecological oncology unit, potentially contributing to fragmented care which may result in diagnostic and treatment delays. Cancer Council Australia provides guidance on optimal treatment timeframes in their endometrial cancer optimal care pathway (ECOCP) which may be used to benchmark care.
Aims
To determine if there are delays to treatment in Western NSW for people with EC when compared to ECOCP.
Methods
Patients with EC diagnosed between January 2015 and December 2024 and treated in a Western NSW cancer service were included. Presentations at multidisciplinary team meetings (MDMs) and intervals between investigation and management were recorded and compared to ECOCP recommendations.
Results
A total of 112 patient files were identified, and 75 patient data was collected after review. The median time between diagnostic endometrial biopsy and surgery was 41.5 days (interquartile range (IQR) 23-53 days). 73/75 (97.3%) patients had a recorded MDM discussion across 5 different MDMs. Median time between surgery and adjuvant therapy was 44 days (IQR 39-57 days, longest 90 days), and 74.5% of patients received adjuvant therapy within the recommended ECOCP time frame of 56 days. There was no difference in outcomes accounting for geographical remoteness, MDM utilised, or by regional cancer centre.
Discussion
Most people with EC in Western NSW receive evidence based, MDM led treatment in a timely manner, however over a quarter experience delays to adjuvant therapy. Qualitative analysis of health records of those affected may identify common themes, and approaches to homogenising and networking pathways to treatment may also improve these data.