# The delayed cancer treatment and economic inequality in Korea: results of common cancers by the time-to-surgery

## TL;DR

This study shows that delayed cancer surgery in Korea leads to worse outcomes and higher costs, especially for lower-income patients.

## Contribution

The study links time-to-surgery with economic disparities and provides policy insights for equitable cancer care in Korea.

## Key findings

- 20.4% of lung cancer patients experienced treatment delays, leading to longer hospital stays and higher costs.
- Lower-income patients showed greater disparities in outcomes related to delayed surgery.
- Extended time-to-surgery increased 5-year mortality risk across all studied cancer types.

## Abstract

Growing concerns regarding the concentration of cancer treatment in the capital city in Korea have raised questions about equitable access to timely and optimal patient care. In this study, we evaluated the impact of time-to-surgery (TTS) on healthcare utilization and outcomes, with the goal of providing policy recommendations for effective quality assessment of cancer care.

This retrospective cohort study analyzed data from 2011 to 2021 obtained from National Health Insurance Service claims. A generalized estimating equation and a Cox proportional hazards model were applied to assess the effects of TTS on length of stay (LOS), medical costs, and 5-year mortality among patients diagnosed with lung, liver, and colorectal cancers. Subgroup analyses were conducted based on patients’ baseline economic status.

Among patients who underwent surgical treatment for lung, liver, or colorectal cancer, 20.4%, 11.4%, and 11.4% experienced treatment delays, respectively. Regardless of cancer type, longer TTS was associated with prolonged LOS and higher medical costs. Moreover, patients with extended TTS demonstrated an increased risk of 5-year mortality. Disparities by income level were evident, with greater differences observed in the lower-income group.

This study highlights the importance of timely surgical treatment for patients with cancer, particularly in relation to income-based disparities. These findings emphasize the need to improve Korea’s concentrated cancer care delivery system to enhance healthcare efficiency and address health literacy gaps affecting treatment by income level.