Trends and variation in the management of oesophagogastric cancer patients: a population-based survey
<p>Abstract</p> <p>Background</p> <p>Previous evidence indicates potential variation in the quality of care of cancer patients. We aimed to examine whether recent changes in the treatment of oesophagogastric cancers have been distributed equally among different patient...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2009-12-01
|
Series: | BMC Health Services Research |
Online Access: | http://www.biomedcentral.com/1472-6963/9/231 |
id |
doaj-11bed8185201407cbdf166f0e54524cf |
---|---|
record_format |
Article |
spelling |
doaj-11bed8185201407cbdf166f0e54524cf2020-11-25T02:30:07ZengBMCBMC Health Services Research1472-69632009-12-019123110.1186/1472-6963-9-231Trends and variation in the management of oesophagogastric cancer patients: a population-based surveyGreenberg David CRhodes MichaelGajperia ChetnaBarbiere Josephine MLyratzopoulos GeorgiosWright Karen A<p>Abstract</p> <p>Background</p> <p>Previous evidence indicates potential variation in the quality of care of cancer patients. We aimed to examine whether recent changes in the treatment of oesophagogastric cancers have been distributed equally among different patient subgroups.</p> <p>Methods</p> <p>We analysed population-based cancer registry data about the treatment patterning of oesophagogastric cancer (other than oesophageal squamous cell carcinoma) during 1995-2006.</p> <p>Results</p> <p>There were 14,077 patients aged ≥40 years (69% men). There was only limited information on stage, and no information on co-morbidity status. During successive triennia, curative surgery use decreased from 28% to 20% (p < 0.001) whilst chemotherapy use increased from 9% to 30% (p < 0.001). Use of palliative surgery and of radiotherapy increased significantly but modestly (7% to 10%, and 9% to 11%, respectively). In multivariable logistic regression adjusting for age group, gender, diagnosis period and tumour type, curative surgery and chemotherapy were used less frequently in more deprived patients [per increasing deprivation group Odds Ratio (OR) = 0.96, 95% Confidence Interval (CI) 0.93-0.99, and OR = 0.90, 95%CI 0.87-0.93, respectively, p < 0.001 for both)]. Chemotherapy was also used less frequently in women (OR = 0.76, p < 0.001).</p> <p>Conclusions</p> <p>During the study period, curative surgery decreased by a third and chemotherapy use increased by more than three-fold, reflecting improvements in the appropriateness and quality of management, but chemotherapy use, in particular, was unequal, both by socioeconomic status and gender.</p> http://www.biomedcentral.com/1472-6963/9/231 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Greenberg David C Rhodes Michael Gajperia Chetna Barbiere Josephine M Lyratzopoulos Georgios Wright Karen A |
spellingShingle |
Greenberg David C Rhodes Michael Gajperia Chetna Barbiere Josephine M Lyratzopoulos Georgios Wright Karen A Trends and variation in the management of oesophagogastric cancer patients: a population-based survey BMC Health Services Research |
author_facet |
Greenberg David C Rhodes Michael Gajperia Chetna Barbiere Josephine M Lyratzopoulos Georgios Wright Karen A |
author_sort |
Greenberg David C |
title |
Trends and variation in the management of oesophagogastric cancer patients: a population-based survey |
title_short |
Trends and variation in the management of oesophagogastric cancer patients: a population-based survey |
title_full |
Trends and variation in the management of oesophagogastric cancer patients: a population-based survey |
title_fullStr |
Trends and variation in the management of oesophagogastric cancer patients: a population-based survey |
title_full_unstemmed |
Trends and variation in the management of oesophagogastric cancer patients: a population-based survey |
title_sort |
trends and variation in the management of oesophagogastric cancer patients: a population-based survey |
publisher |
BMC |
series |
BMC Health Services Research |
issn |
1472-6963 |
publishDate |
2009-12-01 |
description |
<p>Abstract</p> <p>Background</p> <p>Previous evidence indicates potential variation in the quality of care of cancer patients. We aimed to examine whether recent changes in the treatment of oesophagogastric cancers have been distributed equally among different patient subgroups.</p> <p>Methods</p> <p>We analysed population-based cancer registry data about the treatment patterning of oesophagogastric cancer (other than oesophageal squamous cell carcinoma) during 1995-2006.</p> <p>Results</p> <p>There were 14,077 patients aged ≥40 years (69% men). There was only limited information on stage, and no information on co-morbidity status. During successive triennia, curative surgery use decreased from 28% to 20% (p < 0.001) whilst chemotherapy use increased from 9% to 30% (p < 0.001). Use of palliative surgery and of radiotherapy increased significantly but modestly (7% to 10%, and 9% to 11%, respectively). In multivariable logistic regression adjusting for age group, gender, diagnosis period and tumour type, curative surgery and chemotherapy were used less frequently in more deprived patients [per increasing deprivation group Odds Ratio (OR) = 0.96, 95% Confidence Interval (CI) 0.93-0.99, and OR = 0.90, 95%CI 0.87-0.93, respectively, p < 0.001 for both)]. Chemotherapy was also used less frequently in women (OR = 0.76, p < 0.001).</p> <p>Conclusions</p> <p>During the study period, curative surgery decreased by a third and chemotherapy use increased by more than three-fold, reflecting improvements in the appropriateness and quality of management, but chemotherapy use, in particular, was unequal, both by socioeconomic status and gender.</p> |
url |
http://www.biomedcentral.com/1472-6963/9/231 |
work_keys_str_mv |
AT greenbergdavidc trendsandvariationinthemanagementofoesophagogastriccancerpatientsapopulationbasedsurvey AT rhodesmichael trendsandvariationinthemanagementofoesophagogastriccancerpatientsapopulationbasedsurvey AT gajperiachetna trendsandvariationinthemanagementofoesophagogastriccancerpatientsapopulationbasedsurvey AT barbierejosephinem trendsandvariationinthemanagementofoesophagogastriccancerpatientsapopulationbasedsurvey AT lyratzopoulosgeorgios trendsandvariationinthemanagementofoesophagogastriccancerpatientsapopulationbasedsurvey AT wrightkarena trendsandvariationinthemanagementofoesophagogastriccancerpatientsapopulationbasedsurvey |
_version_ |
1724829833410641920 |