Use of chemotherapy in patients with oesophageal, stomach, colon, rectal, liver, pancreatic, lung, and ovarian cancer: an International Cancer Benchmarking Partnership (ICBP) population-based study

• Published in: The Lancet Oncology
• Main Authors: McPhail, Sean, Barclay, Matthew E., Johnson, Shane A., Swann, Ruth, Alvi, Riaz, Barisic, Andriana, Bucher, Oliver, Creighton, Nicola, Denny, Cheryl A., Dewar, Ron A., Donnelly, David W., Dowden, Jeff J., Downie, Laura, Finn, Norah, Gavin, Anna T., Habbous, Steven, Huws, Dyfed W., May, Leon, McClure, Carol A., Møller, Bjørn, Musto, Grace, Nilssen, Yngvar, Saint-Jacques, Nathalie, Sarker, Sabuj, Shack, Lorraine, Tian, Xiaoyi, Thomas, Robert J. S., Thomson, Catherine S., Wang, Haiyan, Woods, Ryan R., You, Hui, Lyratzopoulos, Georgios, Bennett, Damien
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2024
• Subjects: Victoria; Lung; Rectal Neoplasms; Ontario - epidemiology; Benchmarking; State Medicine; Humans; Stomach; Liver; Ovarian Neoplasms - drug therapy - epidemiology; Aged; 80 and over; Middle Aged; Adolescent; Colonic Neoplasms - drug therapy - epidemiology; Male; Female; Adult; Young Adult; /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being; name=SDG 3 - Good Health and Well-being; Newfoundland; Norway; Prince Edward Island
• Online Access: https://pure.qub.ac.uk/en/publications/b8b3c5b4-4579-4ff9-9fe7-be07b118bfbe; https://doi.org/10.1016/S1470-2045(24)00031-7; https://pureadmin.qub.ac.uk/ws/files/595003435/1-s2.0-S1470204524000317-main.pdf

Background There are few data on international variation in chemotherapy use, despite it being a key treatment type for some patients with cancer. Here, we aimed to examine the presence and size of such variation. Methods This population-based study used data from Norway, the four UK nations (England, Northern Ireland, Scotland, and Wales), eight Canadian provinces (Alberta, British Columbia, Manitoba, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, and Saskatchewan), and two Australian states (New South Wales and Victoria). Patients aged 15–99 years diagnosed with cancer in eight different sites (oesophageal, stomach, colon, rectal, liver, pancreatic, lung, or ovarian cancer), with no other primary cancer diagnosis occurring from within the 5 years before to 1 year after the index cancer diagnosis or during the study period were included in the study. We examined variation in chemotherapy use from 31 days before to 365 days after diagnosis and time to its initiation, alongside related variation in patient group differences. Information was obtained from cancer registry records linked to clinical or patient management system data or hospital administration data. Random-effects meta-analyses quantified interjurisdictional variation using 95% prediction intervals (95% PIs). Findings Between Jan 1, 2012, and Dec 31, 2017, of 893 461 patients with a new diagnosis of one of the studied cancers, 111 569 (12·5%) did not meet the inclusion criteria, and 781 892 were included in the analysis. There was large interjurisdictional variation in chemotherapy use for all studied cancers, with wide 95% PIs: 47·5 to 81·2 (pooled estimate 66·4%) for ovarian cancer, 34·9 to 59·8 (47·2%) for oesophageal cancer, 22·3 to 62·3 (40·8%) for rectal cancer, 25·7 to 55·5 (39·6%) for stomach cancer, 17·2 to 56·3 (34·1%) for pancreatic cancer, 17·9 to 49·0 (31·4%) for lung cancer, 18·6 to 43·8 (29·7%) for colon cancer, and 3·5 to 50·7 (16·1%) for liver cancer. For patients with stage 3 colon cancer, the ...