Patterns of Colorectal Cancer Care in Europe, Australia, and New Zealand

Chawla, Neetu; Butler, Eboneé N.; Lund, Jennifer L.; Warren, Joan L.; Harlan, Linda C.; Yabroff, K. Robin

doi:10.1093/jncimonographs/lgt009

Cited by 39 publications

(25 citation statements)

References 85 publications

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“…These trends are likely to be attributable to earlier diagnosis, reduction in postoperative mortality, 52 and more effective treatment. 53,54 For rectal cancer, preoperative radiotherapy and total mesorectal excision reduce local recurrence and extend survival, 55–57 which could account for improvements noted in Canada, Finland, the Netherlands, Norway, Sweden, and the USA, where survival was already high (55–60%) for patients diagnosed in 1995–99 and rose further for those diagnosed during 2005–09 (62–65%). These trends accord with those reported from the Netherlands, 58 Scotland, the Nordic countries, 59 and elsewhere in Europe.…”

Section: Discussionmentioning

confidence: 99%

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

et al. 2015

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Summary Background Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. Methods Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15–99 years) and 75 000 children (age 0–14 years) diagnosed with cancer during 1995–2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. Findings 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005–09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15–19% in North America, and as low as 7–9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10–20% between 1995–99 and 2005–09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995–99 and 2005–09 have generally been slight. For women diagnosed with ovarian cancer in 2005–09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005–09 was high (54–58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18–23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. Interpretation International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer surv...

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Section: Discussionmentioning

confidence: 99%

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

et al. 2015

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“…À Second, the presence of comorbidity, particularly when combined with older age, is usually associated with the under-utilization of radiotherapy [22,23]. It should be recognized, however, that in specific indications such as muscle invasive bladder cancer, where surgery is indicated, radiotherapy could be the preferred option with increased utilization in the elderly with comorbidity [24].…”

Section: Discussionmentioning

confidence: 99%

The optimal utilization proportion of external beam radiotherapy in European countries: An ESTRO-HERO analysis

Borràs

Lievens

Dunscombe

et al. 2015

Radiotherapy and Oncology

139

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a b s t r a c tBackground and purpose: The absolute number of new cancer patients that will require at least one course of radiotherapy in each country of Europe was estimated. Material and methods: The incidence and relative frequency of cancer types from the year 2012 European Cancer Observatory estimates were used in combination with the population-based stage at diagnosis from five cancer registries. These data were applied to the decision trees of the evidence-based indications to calculate the Optimal Utilization Proportion (OUP) by tumour site. Results: In the minimum scenario, the OUP ranged from 47.0% in the Russian Federation to 53.2% in Belgium with no clear geographical pattern of the variability among countries. The impact of stage at diagnosis on the OUP by country was rather limited. Within the 24 countries where data on actual use of radiotherapy were available, a gap between optimal and actual use has been observed in most of the countries. Conclusions: The actual utilization of radiotherapy is significantly lower than the optimal use predicted from the evidence based estimates in the literature. This discrepancy poses a major challenge for policy makers when planning the resources at the national level to improve the provision in European countries.Ó 2015 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology xxx (2015) xxx-xxxThe estimated number of new cancer patients that require radiotherapy is a key parameter for planning the resources needed in a specific country in the framework of a cancer control programme. Most commonly, this calculation has been carried out using a specific proportion, typically the 'gold standard' of 50%, of the incident cases that would require radiotherapy at least http://dx

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“…Our focus was on CRC care, so we excluded studies of primary prevention and screening. We also excluded simulation models based on hypothetical cohorts with assumed patterns of care, because numerous studies have described patterns of CRC care in population-based samples that are inconsistent with treatment pathways or guidelines (14,15). Studies of costs of specific side effects of treatment (eg, nausea) or symptoms of disease were also excluded, because these studies represented only a small component of cancer care.…”

Section: Study Selectionmentioning

confidence: 99%

Economic Studies in Colorectal Cancer: Challenges in Measuring and Comparing Costs

2013

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Estimates of the costs associated with cancer care are essential both for assessing burden of disease at the population level and for conducting economic evaluations of interventions to prevent, detect, or treat cancer. Comparisons of cancer costs between health systems and across countries can improve understanding of the economic consequences of different health-care policies and programs. We conducted a structured review of the published literature on colorectal cancer (CRC) costs, including direct medical, direct nonmedical (ie, patient and caregiver time, travel), and productivity losses. We used MEDLINE to identify English language articles published between 2000 and 2010 and found 55 studies. The majority were conducted in the United States (52.7%), followed by France (12.7%), Canada (10.9%), the United Kingdom (9.1%), and other countries (9.1%). Almost 90% of studies estimated direct medical costs, but few studies estimated patient or caregiver time costs or productivity losses associated with CRC. Within a country, we found significant heterogeneity across the studies in populations examined, health-care delivery settings, methods for identifying incident and prevalent patients, types of medical services included, and analyses. Consequently, findings from studies with seemingly the same objective (eg, costs of chemotherapy in year following CRC diagnosis) are difficult to compare. Across countries, aggregate and patient-level estimates vary in so many respects that they are almost impossible to compare. Our findings suggest that valid cost comparisons should be based on studies with explicit standardization of populations, services, measures of costs, and methods with the goal of comparability within or between health systems or countries. Expected increases in CRC prevalence and costs in the future highlight the importance of such studies for informing health-care policy and program planning.

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Patterns of Colorectal Cancer Care in Europe, Australia, and New Zealand

Cited by 39 publications

References 85 publications

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

The optimal utilization proportion of external beam radiotherapy in European countries: An ESTRO-HERO analysis

Economic Studies in Colorectal Cancer: Challenges in Measuring and Comparing Costs

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