A prospective study on the impact of waiting times for radiotherapy for cervical cancer at Charlotte Maxeke Johannesburg Academic Hospital, South Africa

Background. Radiotherapy plays a vital role in the management of cervical cancer. However, because of high patient load and limited resources, waiting lists are unacceptably long. This is a highly curable malignancy that often occurs in economically active, relatively young women. The impact of treatment delays on society is therefore disproportionately large when compared with many other malignancies. Delays also impact negatively on the healthcare system and place further stress on an already burdened department. Objective. To evaluate the potential impact of radiotherapy delays. Methods. Eighty-one patients requiring radical radiotherapy for cervical cancer were selected. Patients were re-evaluated every 4 weeks while waiting, and again at simulation. Results. Median delay from first consultation to simulation was 55 days. Longer delays were not statistically correlated to tumour progression. Most of the upstaging occurred around 40 - 65 days. One in four patients received blood transfusions and required hospital admission. Four patients needed haemostatic brachytherapy for bleeding. Conclusion. A relationship between time waited and disease progression could not be proven. However, numbers were small and statistical tests were probably underpowered. The study does, however, highlight unacceptably long delays for radiotherapy, and a wait of less than 40 days is recommended.