Progress against cancer in the Netherlands since the late 1980s: An epidemiological evaluation.

Progress against cancer in the Netherlands since the late 1980s: An epidemiological evaluation.:

Progress against cancer through prevention and treatment is often measured by survival statistics only instead of analyzing trends in incidence, survival and mortality simultaneously because of interactive influences. This study combines these parameters of major cancers to provide an overview of the progress achieved in the Netherlands since 1989 and to establish in which areas action is needed. The population-based Netherlands Cancer Registry and Statistics Netherlands provided incidence, 5-year relative survival and mortality of 23 major cancer types. Incidence, survival and mortality changes were calculated as the estimated annual percentage change. Optimal progress was defined as decreasing incidence and/or improving survival accompanied by declining mortality, and deterioration as increasing incidence and/or deteriorating survival accompanied by increasing mortality rates. Optimal progress was observed in 12 of 19 cancer types among males: laryngeal, lung, stomach, gallbladder, colon, rectal, bladder, prostate and thyroid cancer, leukemia, Hodgkin and non-Hodgkin lymphoma. Among females, optimal progress was observed in 12 of 21 cancers: stomach, gallbladder, colon, rectal, breast, cervical, uterus, ovarian and thyroid cancer, leukemia, Hodgkin and non-Hodgkin lymphoma. Deterioration occurred in three cancer types among males: skin melanoma, esophageal and kidney cancer, and among females six cancer types: skin melanoma, oral cavity, pharyngeal, esophageal, pancreatic and lung cancer. Our conceptual framework limits misinterpretations from separate trends and generates a more balanced discussion on progress.

Trends in therapy and survival of advanced stage epithelial ovarian cancer patients in the Netherlands

Trends in therapy and survival of advanced stage epithelial ovarian cancer patients in the Netherlands


Objective
The aim of this study was to describe trends in survival and therapy in advanced stage epithelial ovarian cancer (EOC) in the Netherlands and to determine if changes in therapy affected survival.

Methods
All EOC patients diagnosed in the Netherlands during 1989–2009 were selected from the Netherlands Cancer Registry. Differences in treatment over time were tested by the Cochran-Armitage trend test. Multivariable relative survival analyses were performed to test whether changes in treatment are associated with survival.

Results
23,399 EOC patients were diagnosed, of whom 15,892 (67.9%) in advanced stage (stage ≥ 2b).
In advanced stage patients, the proportion receiving (neo-)adjuvant chemotherapy and optimal debulking (residuals < 1 cm) increased over time in all age groups. In elderly patients (≥ 75 years) a stable proportion (approximately 28%) did not receive any treatment.
Five-year relative survival in advanced stage patients increased from 18% in 1989–1993 to 28% in 2004–2009. In the multivariable model survival improved over time (relative excess risk (RER) of 2004–2009 was 0.71, 95% CI 0.67-0.75 compared to 1989–1993). This RER attenuated to 0.85 (95% CI 0.80-0.90) and 0.91 (95% CI 0.83-0.99) with inclusion of treatment variables in the model (surgery with chemotherapy or optimal surgery with chemotherapy, respectively).
This suggests that the improvement was mainly, although not entirely, caused by changes in treatment.

Conclusion
Treatment in advanced stage EOC patients in the Netherlands improved over the last two decades; more patients received (neo)adjuvant chemotherapy and underwent optimal debulking surgery. Changes in treatment led to partial improvement of survival in EOC patients.

Highlights

► Survival in epithelial ovarian cancer patients improved in the last two decades. ► More Dutch patients receive the recommended (optimal) surgery and chemotherapy. ► Changes in therapy explain most but not all of the improved survival in the Netherlands.

Multinational Comparisons of Health Systems Data, 2011 - The Commonwealth Fund including link to 2011 patient care coordination (11 countries)

"International comparisons of health care systems offer valuable tools to health ministers, policymakers, and academics wishing to evaluate the performance of their country's system. In this chartbook, we use data collected by the Organization for Economic Cooperation and Development (OECD) to compare health care systems and performance on a range of topics, including spending, hospitals, physicians, pharmaceuticals, prevention, mortality, quality of care, and prices. We present data across several industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Whenever possible, we also present the median value of all 34 members of the OECD.......

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abstract: Comparing diagnostic delay in cancer: a cross-sectional study in three European countries with primary care-led health care systems (UK, Netherlands, Sweden)

Conclusions. A large-scale study comparing cancer delays in European countries and based on primary care-held records is feasible but would require supplementary sources of data in order to maximize information on demographic variables, the cancer stage at diagnosis and treatment details. Such a large-scale study is timely and desirable since our findings suggest systematic differences in the way cancer is managed in the three countries.

full free access: Research output on primary care in Australia, Canada, Germany, the Netherlands, the United Kingdom, and the United States: bibliometric analysis - bmj.com

What is already known on this topic

• The UK Research Assessment Exercise in 2008 rated 50% of UK primary care research as world class or internationally excellent, but no direct international comparisons exist

What this study adds

• In six countries with strong primary care, the United Kingdom and the Netherlands produce the most cited primary care led primary care research
• Identifying research on primary care that is carried out by primary care researchers is difficult using routine bibliometric methods
• Only 29% of research papers on primary care had at least one primary care researcher as author

Gynecologic Cancer - the Netherlands - Starz Foundation - samen sterk in de strijd tegen gynaecologische kanker

abstract: Unambiguous test results or individual independence? The role of clients and families in predictive BRCA-testing in the Netherlands compared to the US