International differences in survival from colon cancer : more effective care versus less complete cancer registration.
Background Reporting of a recent international comparison of cancer survival rates has left an impression of inadequate treatment of patients in the UK but failed to address adequately the extent to which differences in survival may reflect variation in the completeness and accuracy of cancer registration.
The aim of this study was to quantify the extent to which differences in registration practice may confound comparisons of survival from cancer of the colon.
Methods A cohort of incident cases of colon cancer identified from records held by the North Western Regional Cancer Registry was used to simulate the effects on survival of changes in clinical and registration factors.
The survival curve produced after each simulation was compared with that for aggregated data from 21 European registries.
Results The observed survival differences were not explained by more effective primary treatment or by misclassification of in situ cases as malignant disease, whereas the exclusion of cases with only a clinical diagnosis produced estimates close to those of the European cohort.
Conclusion The observed survival differentials may not be due to differences in the quality of care but may reflect the failure of some European registries to register all patients with advanced disease.
Mots-clés Pascal : Tumeur maligne, Côlon, Homme, Epidémiologie, Etude comparative, International, Taux, Survie, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie
Mots-clés Pascal anglais : Malignant tumor, Colon, Human, Epidemiology, Comparative study, International, Rate, Survival, Digestive diseases, Intestinal disease, Colonic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0079023
Code Inist : 002B04B. Création : 14/05/1998.