Variation in survival of children with cancer within a region of the United Kingdom.
A population-based study of survival of 678 children, age less than 15 years, diagnosed with cancer in the Southwest region of the United Kingdom showed an improvement in 5-year survival from 53% between 1976 and 1980 to 64% between 1981 and 1985 (P=0.008).
Survival varied significantly among the five counties that make up the region (P=0.0008) ; the differences were greatest for central nervous system (CNS) tumors.
The expertise of local hospitals and entrance into national trials was examined.
The region has nine hospitals acting as primary treatment hospitals for children with cancer, two neurosurgical units, and one regional oncology unit.
Four of the primary hospitals saw more than six children per year and were designated « large » centers.
Five saw fewer than six patients per year and were designated « small » hospitals.
There was a significant difference in survival of patients according to the number of patients treated per year per hospital.
A hospital that treated fewer than six patients per year was designated « small » and six or more designated « large. » At 5 years, patients with CNS tumors experienced a 58% survival rate in large hospitals and a 41% survival rate in small hospitals. (P=0.03).
The rate of entrance into trials for all malignancies did not differ between large (30%) and small (27%) centers.
Only 5% of children with CNS tumors were placed on national trials.
There was no difference in survival rates for CN...
Mots-clés Pascal : Tumeur maligne, Hémopathie maligne, Enfant, Homme, Pronostic, Survie, Echelon régional, Epidémiologie, Variation, Royaume Uni, Europe, Santé publique
Mots-clés Pascal anglais : Malignant tumor, Malignant hemopathy, Child, Human, Prognosis, Survival, Regional scope, Epidemiology, Variations, United Kingdom, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0150533
Code Inist : 002B04C. Création : 199608.