TY - JOUR
T1 - A comparison of surgical and radiotherapy breast cancer therapy utilization in Canada (British Columbia), Scotland (Dundee) and Australia (Western Australia) with models of "optimal" therapy
AU - Fong, A.
AU - Shafiq, J.
AU - Saunders, C.
AU - Thompson, A. M.
AU - Tyldesley, S.
AU - Olivotto, I. A.
AU - Barton, M. B.
AU - Dewar, J. A.
AU - Jacob, S.
AU - Ng, W.
AU - Speers, C.
AU - Delaney, G. P.
N1 - Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/1/1
Y1 - 2012/1/1
N2 - Background: Different jurisdictions report different breast cancer treatment rates. Evidence-based utilization models may be specific to derived populations. We compared predicted optimal with actual radiotherapy utilization in British Columbia, Canada; Dundee, Scotland; and Perth, Western Australia. Design: Data were analyzed for differences in demography, tumor, and treatment. Epidemiological data were fitted to published Australian optimal radiotherapy utilization trees and region-specific optimal treatment rates were calculated. Optimal and actual surgery/radiotherapy rates from 2 population-based and 1 institution-based registries were compared for patients diagnosed with breast cancer between 2000 and 2004, and 2002 for British Columbia. Results: Mastectomy rates differed between British Columbia (40%), Western Australia (44%), and Dundee (47%, p <0.01). Radiotherapy rates differed between British Columbia (60%), Western Australia (52%), and Dundee (49%, p <0.01). Actual radiotherapy utilization rates were lower than optimal estimates. Region-specific optimal utilization rates at diagnosis varied from 57% to 71% for radiotherapy and 62% to 64% when taking into account patient preference. Variation was attributed to local differences in demography and tumor stage. Conclusions: Actual treatment rates varied, and were associated with patterns of care and guideline differences. Actual radiotherapy rates were lower than optimal rates. Differences between optimal and actual utilization may be due to access shortfalls, and patient preference. Crown
AB - Background: Different jurisdictions report different breast cancer treatment rates. Evidence-based utilization models may be specific to derived populations. We compared predicted optimal with actual radiotherapy utilization in British Columbia, Canada; Dundee, Scotland; and Perth, Western Australia. Design: Data were analyzed for differences in demography, tumor, and treatment. Epidemiological data were fitted to published Australian optimal radiotherapy utilization trees and region-specific optimal treatment rates were calculated. Optimal and actual surgery/radiotherapy rates from 2 population-based and 1 institution-based registries were compared for patients diagnosed with breast cancer between 2000 and 2004, and 2002 for British Columbia. Results: Mastectomy rates differed between British Columbia (40%), Western Australia (44%), and Dundee (47%, p <0.01). Radiotherapy rates differed between British Columbia (60%), Western Australia (52%), and Dundee (49%, p <0.01). Actual radiotherapy utilization rates were lower than optimal estimates. Region-specific optimal utilization rates at diagnosis varied from 57% to 71% for radiotherapy and 62% to 64% when taking into account patient preference. Variation was attributed to local differences in demography and tumor stage. Conclusions: Actual treatment rates varied, and were associated with patterns of care and guideline differences. Actual radiotherapy rates were lower than optimal rates. Differences between optimal and actual utilization may be due to access shortfalls, and patient preference. Crown
UR - http://www.scopus.com/inward/record.url?scp=84858136200&partnerID=8YFLogxK
U2 - 10.1016/j.breast.2012.02.014
DO - 10.1016/j.breast.2012.02.014
M3 - Article
C2 - 22425535
SN - 0960-9776
JO - Breast
JF - Breast
ER -
