A NEW national study published ahead of print in JCO Oncology Practice reveals a steady increase in time to treatment initiation (TTI) across all 30 of the most prevalent cancer types, with early-stage diagnoses now a major driver of these delays. The findings are based on a retrospective analysis of 5,615,193 cancer cases diagnosed between 2004 and 2015 using data from the National Cancer Database.
The study shows that median TTI rose from 21 days in 2004 to 28 days in 2015, marking a significant 7-day increase over 11 years. Across all cancer types, the median time to start treatment was 26 days, with a wide interquartile range of 6 to 47 days. Notably, no individual cancer type experienced a reduction in TTI during this time.
The proportion of patients diagnosed with Stage I cancer increased sharply from 28.4% in 2004 to 43.2% in 2015, an increase of more than 52%. At the same time, the median TTI for Stage I patients doubled from 14 to 28 days. Researchers found that cancer stage was the most important predictor of changes in TTI for 16 cancer types, with all associations showing high statistical significance (P <0.001). The study cohort was demographically representative of the broader cancer population, with a median age of 65, 51.5% female, and 86.1% White. The most common cancers in the dataset were breast (22.1%), lung (18.8%), and prostate (16.6%). These findings point to an urgent challenge in oncology care. While earlier diagnoses typically promise better outcomes, the accompanying surge in early-stage cases appears to be overwhelming treatment systems. This growing lag between diagnosis and treatment could have far-reaching implications for patient outcomes and healthcare delivery. Reference: Dafflisio GJ et al. Time to Treatment Initiation for the 30 Most Prevalent Cancer Types: Trends and Predictors of Change. JCO Oncol Pract. 2025:OP2300614. doi: 10.1200/OP.23.00614. [Online ahead of print].
