Surveying Patients to Assess Timeliness of Cancer Diagnosis

Objectives

To develop and test feasibility of patient survey-based quality measures to assess timeliness of cancer diagnosis.

Methods

We developed a 39-item survey through review of literature and measures, input from experts, and cognitive testing. We field-tested it in an urban health system among patients with new cancer diagnoses (prior 3-9 months); surveys were administered by web and mail September-October 2023. We calculated top-box scores and conducted confirmatory factor analysis for evaluative items and assessed construct validity through correlations to the diagnostic interval, number of health care visits, and overall assessments of care quality.

Results

The overall response rate was 23.9 %. The 276 respondents primarily spoke English (89 %), were non-Hispanic white (66 %), age 65+ (68 %), and college graduates (67 %). More than a quarter believed their cancer could have been diagnosed much sooner. Better communication with health care professionals, timely receipt of usual and specialty care, and ease of receipt and follow-up of tests, X-rays, and scans were positively associated with patients reporting that health care professionals could not have diagnosed the cancer much sooner. Patients reporting it was always easy to receive needed tests, X-rays, and scans and that they always received follow-up results were more than three times more likely to report a diagnostic interval less than or equal to 30 days (p<0.001).

Conclusions

Patients can report on barriers to timely diagnosis associated with the length of their cancer diagnostic interval. Surveys are a promising source of information regarding opportunities to improve timeliness of cancer diagnosis.