Excess-mortality calculator
Enter a delay length and a cancer indication. The tool applies a published hazard ratio to estimate the associated excess mortality risk, shown with the 95% confidence interval carried through from the source study.
Set this to the real delay — e.g. a plan's published median decision time, or a documented appeal turnaround.
Selecting a plan fills the delay from its published median turnaround. See dashboard.
Illustrative default. Edit to your stage/scenario.
e.g. annual volume a plan delays.
The baseline figure is an input, not a sourced statistic. Excess-deaths output is illustrative unless you supply a baseline drawn from your own population. illustrative
A transparent population-level statistical model, not a prediction about any individual and not a diagnosis. It applies published hazard ratios (primarily Hanna et al., BMJ 2020) to the delay you enter and shows the 95% confidence interval carried through from the source study. Where an interval crosses 1.0 the indication is flagged as not statistically significant. This is not medical advice — discuss any treatment-timing decision with your treating physician.
How the number is calculated
No black box. Each indication carries a hazard ratio (HR) for death per 4 weeks of delay, taken directly from the source meta-analysis. For a delay of d days, the estimated relative mortality multiplier is:
excess mortality risk (%) = (HR(d / 28) − 1) × 100
estimated excess deaths = baseline mortality × (HR(d / 28) − 1) × patients delayed
Converting the per-4-week hazard ratio to a per-day basis uses a log-linear interpolation (HR(days/28)) — an approach explicitly supported by Hanna et al. 2020; see the methodology for its limits.
Confidence intervals are produced by running the same formula on the published lower and upper HR bounds. Where the interval crosses 1.0, the tool says so — for that indication, a delay's effect may be statistically indistinguishable from zero. See the full methodology for assumptions and limitations.
The source data
Hazard ratios per 4 weeks of delay, with the 95% confidence interval and the source for each indication.
| Indication | Modality | HR / 4 wks | 95% CI | Significant | Source |
|---|
Sources
- Hanna TP, King WD, Thibodeau S, et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ 2020;371:m4087. doi:10.1136/bmj.m4087
- Ungvari Z, et al. Treatment delay significantly increases mortality in colorectal cancer: a meta-analysis. GeroScience 2025;47(3):5337–5353. doi:10.1007/s11357-025-01648-z
- Ungvari A, et al. Quantifying the impact of treatment delays on breast cancer survival outcomes: a comprehensive meta-analysis. GeroScience 2025. doi:10.1007/s11357-025-01719-1
- CMS Interoperability & Prior Authorization Final Rule (CMS-0057-F) — public denial/turnaround reporting. cms.gov