Pilot Study of Feasibility to Reduce Lead Times in Colorectal Cancer Treatment in a Moroccan Cancer Center: A Convergent Mixed Method Study

Abstract Background: Short lead time in colorectal cancer treatment is important to improve patient outcomes. This study aimed to explore factors associated with longer lead times between the first consultation and the therapeutic decision, and between the first consultation and the treatment initiation.Results: 83 patients were included in the quantitative analysis. The median T1 duration was 16.53 days, a delay statistically associated with younger age, low-income patients, rectal cancer, and radiotherapy as first treatment. The median T2 duration was 45.36 days. Basic medical insurance and rectal cancer were statistically associated with these delays. In-depth interviews confirmed the impact of the type of medical coverage on the lengthening of the delays. Radiotherapy and the occasional unavailability of equipment were also noted. The objectives set to decrease the two waiting times would be achievable through increased coordination between the different stakeholders and optimization of the care procedures all along, with an effective and efficient hospital supply chain enhanced by a digital orientation.Conclusion: In this pilot study performed in a low-mid income country, the main reasons for delays in the treatment of colorectal cancer were the patient's low socio-economic level and rectal cancer. Increasing coordination and adapted procedures may improve these results.