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Audit of waiting time‐to‐treatment of atypical endometrial hyperplasia

BACKGROUND: Atypical endometrial hyperplasia (AEH) is the precursor lesion in endometrial carcinoma, the most common gynaecological malignancy in New Zealand, with inequities in disease burden and outcome for Māori and Pacific women. AIMS: In women diagnosed with AEH at two hospitals, to audit five...

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Autores principales: Anderson, Annabel, Cooper, Juliet, Oyston, Charlotte, Miles, Carina, Sowden, Katherine, Peiris‐John, Roshini, Wise, Michelle R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796385/
https://www.ncbi.nlm.nih.gov/pubmed/35730741
http://dx.doi.org/10.1111/ajo.13551
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author Anderson, Annabel
Cooper, Juliet
Oyston, Charlotte
Miles, Carina
Sowden, Katherine
Peiris‐John, Roshini
Wise, Michelle R.
author_facet Anderson, Annabel
Cooper, Juliet
Oyston, Charlotte
Miles, Carina
Sowden, Katherine
Peiris‐John, Roshini
Wise, Michelle R.
author_sort Anderson, Annabel
collection PubMed
description BACKGROUND: Atypical endometrial hyperplasia (AEH) is the precursor lesion in endometrial carcinoma, the most common gynaecological malignancy in New Zealand, with inequities in disease burden and outcome for Māori and Pacific women. AIMS: In women diagnosed with AEH at two hospitals, to audit five standards of care for surgical management and time‐to‐treatment, and identify variation in care by ethnicity and other factors. MATERIALS AND METHODS: Demographic, referral, diagnostic and treatment characteristics were collected for women with a new AEH diagnosis between 1/1/2019 and 31/12/2020. Surgical management and time‐to‐treatment were audited against Royal College of Obstetricians and Gynaecologists and New Zealand Ministry of Health Faster Cancer Treatment recommendations. RESULTS: Of 124 participants, 60% were Pacific, 86% premenopausal, and 80% had obesity. For 55 women managed surgically, surgical standards of care were met. There were delays between referral, diagnosis and treatment – only 18% and 56% of women met the 62‐day (referral to treatment) and 31‐day (decision‐to‐treat to treatment) targets, respectively. Wait times were prolonged for women who had dilation and curettage (vs pipelle), magnetic resonance imaging (MRI) (vs no MRI), and surgery (vs medical management). Ethnic disparities were not identified for any standard. DISCUSSION: Delays to treatment were found throughout women's journeys. Hospital services can streamline their clinical pathways for women referred for abnormal uterine bleeding, flagging obesity as a high suspicion for cancer indicator, increasing access to endometrial sampling in primary care and establishing ‘one‐stop‐shop’ outpatient assessment with empiric initiation of intrauterine progestogen.
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spelling pubmed-97963852022-12-30 Audit of waiting time‐to‐treatment of atypical endometrial hyperplasia Anderson, Annabel Cooper, Juliet Oyston, Charlotte Miles, Carina Sowden, Katherine Peiris‐John, Roshini Wise, Michelle R. Aust N Z J Obstet Gynaecol Original Articles BACKGROUND: Atypical endometrial hyperplasia (AEH) is the precursor lesion in endometrial carcinoma, the most common gynaecological malignancy in New Zealand, with inequities in disease burden and outcome for Māori and Pacific women. AIMS: In women diagnosed with AEH at two hospitals, to audit five standards of care for surgical management and time‐to‐treatment, and identify variation in care by ethnicity and other factors. MATERIALS AND METHODS: Demographic, referral, diagnostic and treatment characteristics were collected for women with a new AEH diagnosis between 1/1/2019 and 31/12/2020. Surgical management and time‐to‐treatment were audited against Royal College of Obstetricians and Gynaecologists and New Zealand Ministry of Health Faster Cancer Treatment recommendations. RESULTS: Of 124 participants, 60% were Pacific, 86% premenopausal, and 80% had obesity. For 55 women managed surgically, surgical standards of care were met. There were delays between referral, diagnosis and treatment – only 18% and 56% of women met the 62‐day (referral to treatment) and 31‐day (decision‐to‐treat to treatment) targets, respectively. Wait times were prolonged for women who had dilation and curettage (vs pipelle), magnetic resonance imaging (MRI) (vs no MRI), and surgery (vs medical management). Ethnic disparities were not identified for any standard. DISCUSSION: Delays to treatment were found throughout women's journeys. Hospital services can streamline their clinical pathways for women referred for abnormal uterine bleeding, flagging obesity as a high suspicion for cancer indicator, increasing access to endometrial sampling in primary care and establishing ‘one‐stop‐shop’ outpatient assessment with empiric initiation of intrauterine progestogen. John Wiley and Sons Inc. 2022-06-22 2022-10 /pmc/articles/PMC9796385/ /pubmed/35730741 http://dx.doi.org/10.1111/ajo.13551 Text en © 2022 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Anderson, Annabel
Cooper, Juliet
Oyston, Charlotte
Miles, Carina
Sowden, Katherine
Peiris‐John, Roshini
Wise, Michelle R.
Audit of waiting time‐to‐treatment of atypical endometrial hyperplasia
title Audit of waiting time‐to‐treatment of atypical endometrial hyperplasia
title_full Audit of waiting time‐to‐treatment of atypical endometrial hyperplasia
title_fullStr Audit of waiting time‐to‐treatment of atypical endometrial hyperplasia
title_full_unstemmed Audit of waiting time‐to‐treatment of atypical endometrial hyperplasia
title_short Audit of waiting time‐to‐treatment of atypical endometrial hyperplasia
title_sort audit of waiting time‐to‐treatment of atypical endometrial hyperplasia
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796385/
https://www.ncbi.nlm.nih.gov/pubmed/35730741
http://dx.doi.org/10.1111/ajo.13551
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