Development of key performance indicator (KPI) for real-time monitoring of treatment of early breast cancer to control socioeconomic and indigenous systemic bias

10566 Background: Disparity in outcome for different cancer groups exist particularly for indigenous and poor socioeconomic background. Patient and treatment data on a population basis was examined. Methods: Population data for the state of Queensland, Australia (population 5.2M) collected by Cancer Alliance Queensland as part of government cancer registry roles plus additional linked data available as a gazetted quality assurance committee was examined to find patients with early breast cancer treated with surgery, chemotherapy (CT) and radiotherapy (RT) between 2005-2015. Results: A cohort of 8279 women received treatment with 89.3% having the surgery, CT, RT sequence. Time to completement threshold was 37 weeks using empirical cutpoint estimation in Stata. Overall survival (OS) was 94% at 5 years if < 37 weeks versus 88.5% if not. (p < 0.001). Multivariate analysis of socioeconomic and clinical characteristics for survival was also significant for increasing age, indigenous status, socioeconomic disadvantage, multiple co morbidities and advancing disease stage. Private hospital cases had a better outcome. When delay is analysed between treatments, only time to CT from surgery > 9.5 weeks was significant for OS (HR 1.42 p < 0.001). Indigenous status, socioeconomic status and private facility no longer were significant. Multiple co morbidities and advanced stage were still significantly associated with poorer survival. Funnel plots of treatment centre show the association with public hospital treatment and lower volume centre with delay. Conclusions: This data is retrospective so can inform local service evaluation but implementation of a KPI for delay to adjuvant chemotherapy of 9.5 weeks can provide real time targets for patient care. We measured delay in the recent 5 years (before survival available) which shows consistent delays and it will included as a reporting function of MDT management software. Whilst the increased use of neoadjuvant CT will assist, systematic reporting of this KPI has potential to remove treatment biases for indigenous and lower socioeconomic patients. More recent data will be available for presentation.