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ABSTRACT BACKGROUND Protracted times to diagnosis of cancer can lead to increased patient anxiety, and in some cases, disease progression and worse outcomes. This study assessed the time to

diagnosis for melanoma, and its variability, according to patient-, disease-, and system-level factors. METHODS This is a descriptive, cross-sectional study in Ontario, Canada from

2007–2019. We used administrative health data to measure the diagnostic interval (DI)–and its two subintervals–the primary care subinterval (PCI) and specialist care subinterval (SCI).

Multivariable quantile regression was used. RESULTS There were 33,371 melanoma patients. The median DI was 36 days (interquartile range [IQR]: 8–85 days), median PCI 22 days (IQR: 6–54

days), and median SCI 6 days (IQR: 1–42 days). Increasing comorbidity was associated with increasing DI. Residents in the most deprived neighbourhoods and those in rural areas experienced

shorter DIs and PCIs, but no differences in SCI. There was substantial variation in the DI and SCI across health regions, but limited differences in the PCI. Finally, patients with a history

of non-melanoma skin cancer, and those previously established with a dermatologist experienced significantly longer DI, PCI, and SCI. DISCUSSION This study found variability in the melanoma

DI, notably by system-level factors. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through

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Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS CAUSES OF DEATH AMONG PATIENTS WITH CUTANEOUS MELANOMA: A US POPULATION-BASED STUDY Article Open access 24

June 2023 EPIDEMIOLOGY AND SOCIOECONOMIC FACTORS OF NONMELANOMA SKIN CANCER IN THE MIDDLE EAST AND NORTH AFRICA 1990 TO 2021 Article Open access 23 May 2025 GLOBAL, REGIONAL, AND NATIONAL

TRENDS IN THE BURDEN OF MELANOMA AND NON-MELANOMA SKIN CANCER: INSIGHTS FROM THE GLOBAL BURDEN OF DISEASE STUDY 1990–2021 Article Open access 18 February 2025 DATA AVAILABILITY The dataset

from this study is held securely in coded form at ICES. While legal data sharing agreements between ICES and data providers (e.g., healthcare organisations and government) prohibit ICES from

making the dataset publicly available, access may be granted to those who meet pre-specified criteria for confidential access, available at www.ices.on.ca/DAS (email: [email protected]).

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references ACKNOWLEDGEMENTS This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). This

study also received funding from the Canadian Institutes of Health Research (CIHR) Doctoral Award. This document used data adapted from the Statistics Canada Postal CodeOM Conversion File,

which is based on data licensed from Canada Post Corporation, and/or data adapted from the Ontario Ministry of Health Postal Code Conversion File, which contains data copied under license

from © Canada Post Corporation and Statistics Canada. Parts of this material are based on data and/or information compiled and provided by: Canadian Institute for Health Information (CIHI),

MOH, Ontario Health (OH), and Toronto Community Health Profiles. The analyses, conclusions, opinions and statements expressed herein are solely those of the authors and do not reflect those

of the funding or data sources; no endorsement is intended or should be inferred. We thank the Toronto Community Health Profiles Partnership for providing access to the Ontario

Marginalisation Index. FUNDING The authors received no specific funding for this work. MEM is supported by a Canadian Institutes of Health Research Doctoral Award. AUTHOR INFORMATION Author

notes * These authors contributed equally: Yuka Asai, Hugh Langley, Nicole J. Look Hong, Frances C. Wright. * These authors jointly supervised this work: Timothy P. Hanna, Patti A. Groome.

AUTHORS AND AFFILIATIONS * Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada Meaghan E. Mavor, Timothy P. Hanna & Patti A. Groome * Division of Cancer Care

and Epidemiology, Cancer Research Institute at Queen’s University, Kingston, ON, Canada Meaghan E. Mavor, Timothy P. Hanna & Patti A. Groome * Department of Oncology, Queen’s University,

Kingston, ON, Canada Timothy P. Hanna & Hugh Langley * ICES at Queen’s University, Kingston, ON, Canada Timothy P. Hanna & Paul Nguyen * Division of Dermatology, Department of

Medicine, Queen’s University, Kingston, ON, Canada Yuka Asai * South East Regional Cancer Program, Kingston, ON, Canada Hugh Langley * Surgical Oncology, Department of Surgery, Sunnybrook

Health Sciences Centre, Toronto, ON, Canada Nicole J. Look Hong & Frances C. Wright * Department of Surgery, University of Toronto, Toronto, ON, Canada Nicole J. Look Hong & Frances

C. Wright * Surgical Oncology Program, Cancer Care Ontario – Ontario Health, Toronto, ON, Canada Frances C. Wright Authors * Meaghan E. Mavor View author publications You can also search for

this author inPubMed Google Scholar * Timothy P. Hanna View author publications You can also search for this author inPubMed Google Scholar * Yuka Asai View author publications You can also

search for this author inPubMed Google Scholar * Hugh Langley View author publications You can also search for this author inPubMed Google Scholar * Nicole J. Look Hong View author

publications You can also search for this author inPubMed Google Scholar * Frances C. Wright View author publications You can also search for this author inPubMed Google Scholar * Paul

Nguyen View author publications You can also search for this author inPubMed Google Scholar * Patti A. Groome View author publications You can also search for this author inPubMed Google

Scholar CONTRIBUTIONS MEM had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. TPH and PAG contributed

equally to this work as co-senior authors. MEM: conceptualisation, design, statistical analyses, interpretation, original draft, revision, review. YA: clinical expertise, interpretation,

review. HL: clinical expertise, interpretation, review. NJLH: clinical expertise, interpretation, review. PN: cohort creation, data processing, review. FCW: clinical expertise,

interpretation, review. TPH: conceptualisation, design, supervision, interpretation, revision. PAG: conceptualisation, design, supervision, interpretation, revision. CORRESPONDING AUTHOR

Correspondence to Meaghan E. Mavor. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing interests. ETHICS APPROVAL This project has been approved by the Health Sciences

Research Ethics Board at Queen’s University. Participant consent has been waived as the research falls under Article 5.5A of the Tri-Council Policy Statement 2 (TCPS 2). ADDITIONAL

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Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Mavor, M.E., Hanna, T.P., Asai, Y. _et al._ Factors associated with the melanoma diagnostic interval in Ontario, Canada: a

population-based study. _Br J Cancer_ 130, 483–495 (2024). https://doi.org/10.1038/s41416-023-02518-1 Download citation * Received: 21 February 2023 * Revised: 15 November 2023 * Accepted:

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