America's future? Spain's "fast track" cancer program: 37 days from lung cancer detection to initial treatment!

http://www.ncbi.nlm.nih.gov/pubmed/21829194


"Mean time from detection of suspected cancer in primary care to start of initial treatment was 32 days for breast, 30 for colorectal and 37 for lung cancer (2009)."



Br J Cancer. 2011 Aug 9. doi: 10.1038/bjc.2011.308. [Epub ahead of print]
Implementing a Cancer Fast-track Programme between primary and specialised care in Catalonia (Spain): a mixed methods study.
Prades J, Espinàs JA, Font R, Argimon JM, Borràs JM.
Source
1] Catalonian Cancer Plan, Duran i Reynals Hospital, Av. Gran Via de l'Hospitalet 199-203, Hospitalet de Llobregat, Barcelona 08908, Spain [2] Clinical Sciences Department, Bellvitge Biomedical Research Institute (Institut d'Investigació Biomèdica de Bellvitge - IDIBELL), University of Barcelona, Av. Gran Via de l'Hospitalet 199-203, Hospitalet de Llobregat, Barcelona 08908, Spain.

Abstract
Background:The Cancer Fast-track Programme's aim was to reduce the time that elapsed between well-founded suspicion of breast, colorectal and lung cancer and the start of initial treatment in Catalonia (Spain). We sought to analyse its implementation and overall effectiveness.

Methods:A quantitative analysis of the programme was performed using data generated by the hospitals on the basis of seven fast-track monitoring indicators for the period 2006-2009. In addition, we conducted a qualitative study, based on 83 semistructured interviews with primary and specialised health professionals and health administrators, to obtain their perception of the programme's implementation.

Results:About half of all new patients with breast, lung or colorectal cancer were diagnosed via the fast track, though the cancer detection rate declined across the period. Mean time from detection of suspected cancer in primary care to start of initial treatment was 32 days for breast, 30 for colorectal and 37 for lung cancer (2009). Professionals associated with the implementation of the programme showed that general practitioners faced with suspicion of cancer had changed their conduct with the aim of preventing lags. Furthermore, hospitals were found to have pursued three specific implementation strategies (top-down, consensus-based and participatory), which made for the cohesion and sustainability of the circuits.

Conclusion:The programme has contributed to speeding up diagnostic assessment and treatment of patients with suspicion of cancer, and to clarifying the patient pathway between primary and specialised care.

British Journal of Cancer advance online publication, 9 August 2011; doi:10.1038/bjc.2011.308 www.bjcancer.com.