A comparison of systemic breast cancer therapy utilization in Canada (British Columbia), Scotland (Dundee), and Australia (Western Australia) with models of "optimal" therapy

被引:9
作者
Fong, Andrew [1 ,2 ]
Shafiq, Jesmin [1 ,2 ]
Saunders, Christobel [5 ]
Thompson, Alastair [4 ]
Tyldesley, Scott [3 ]
Olivotto, Ivo A. [3 ]
Barton, Michael B. [1 ,2 ]
Dewar, John A. [4 ]
Jacob, Susannah [1 ,2 ]
Ng, Weng [1 ,2 ]
Speers, Caroline [3 ]
Delaney, Geoff P. [1 ,2 ,6 ]
机构
[1] Liverpool Hosp, Collaborat Canc Outcomes Res & Evaluat, Liverpool, NSW 1871, Australia
[2] Univ New S Wales, Fac Med, Sydney, NSW, Australia
[3] British Columbia Canc Agcy, Vancouver, BC V5Z 4E6, Canada
[4] Univ Dundee, Dundee Canc Ctr, Dundee DD1 4HN, Scotland
[5] Univ Western Australia, Sch Surg, Perth, WA 6009, Australia
[6] Univ Western Sydney, Sydney, NSW, Australia
关键词
Breast cancer; Cancer; Chemotherapy; Endocrine therapy; Evidence-based medicine; Treatment; INTERNATIONAL EXPERT CONSENSUS; RADIOTHERAPY; HIGHLIGHTS;
D O I
10.1016/j.breast.2012.01.006
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Different jurisdictions report different breast cancer treatment rates. Evidence-based optimal utilization models may be specific to the derived population. We compared predicted optimal with actual endocrine and chemotherapy utilization in British Columbia, Canada; Dundee, Scotland; and Perth, Western Australia. Design: Data were analyzed for differences in demography, tumour, and treatment. Epidemiological data were fitted to published Australian optimal radiotherapy utilization trees and region-specific optimal treatment rates were calculated. Optimal and actual systemic therapy rates from 2 population-based and 1 institution-based cancer registries were compared for patients diagnosed with breast cancer between 2000-2004, and 2002 for British Columbia. Results: Chemotherapy rates differed between British Columbia (32%), Perth (29%), and Dundee (24%, p = 0.014). Endocrine therapy rates were similar between British Columbia (56%), Perth (59%), and Dundee (64%, p > 0.05). Actual utilization rates were lower than optimal estimates for chemotherapy, but higher for endocrine therapy. Region-specific optimal utilization rates at diagnosis varied between 50-56% for chemotherapy, and 49-54% for endocrine therapy. Variation was attributed to local differences in demographics, and tumour stage. Conclusion: Actual treatment rates varied. There was lower than estimated optimal chemotherapy use but higher than expected use of endocrine therapy. Crown Copyright (c) 2012 Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:562 / 569
页数:8
相关论文
共 20 条
[1]  
Abe O, 2005, LANCET, V366, P2087, DOI 10.1016/s0140-6736(05)66544-0
[2]  
[Anonymous], 2009, BREAST CANC TREATM P
[3]  
[Anonymous], 2009, CANC MAN GUID BREAST
[4]  
[Anonymous], 2001, CLIN PRACT GUID MAN
[5]  
[Anonymous], 2009, EARL LOC ADV BREAST
[6]  
Australian Association of Cancer Registries, 2007, CANC AUSTR 2003
[7]  
Centre for Epidemiology and Research, 2006, 2005 REP AD HLTH NEW
[8]   Estimation of an optimal radiotherapy utilization rate for breast carcinoma - A review of the evidence [J].
Delaney, G ;
Barton, M ;
Jacob, S .
CANCER, 2003, 98 (09) :1977-1986
[9]   Establishing treatment benchmarks for mammography-screened breast cancer population based on a review of evidence-based clinical guidelines [J].
Delaney, Geoff ;
Shafiq, Jesmin ;
Chappell, Genevieve ;
Barton, Michael .
CANCER, 2008, 112 (09) :1912-1922
[10]   Patients' preferences for adjuvant chemotherapy in early breast cancer: what makes AC and CMF worthwhile now? [J].
Duric, VM ;
Stockler, MR ;
Heritier, S ;
Boyle, F ;
Beith, J ;
Sullivan, A ;
Wilcken, N ;
Coates, AS ;
Simes, RJ .
ANNALS OF ONCOLOGY, 2005, 16 (11) :1786-1794