Hospital variables associated with quality of care for breast cancer patients

Article Abstract:

The prognosis for patients with breast cancer is improved with early detection and proper treatment of the disease. Screening mammography (breast X-ray) is widely used to detect breast cancer in its early stages. Certain treatments are recommended for specific findings. This study examined the attributes of hospitals that contributed to quality care for breast cancer patients. Quality of care was defined by a hospital's use of five variables that contribute to better patient outcome. These variables include: early detection, hormone receptor determination, adjuvant therapy when indicated, radiation therapy when indicated, and axillary lymph node dissection when indicated. Although over 80 percent of all cases were detected early, at some hospitals more than 23 percent of breast cancer patients were diagnosed in late stages. Attributes associated with such hospitals included an urban location, many poorly insured patients, and fewer breast cancer patients treated. Failure of hospitals to use two of the variables, adjuvant therapy and radiation therapy, was widely reported with wide ranges between hospitals. No hospital attributes were shown to be related to omission of adjuvant therapy. Omission of radiation therapy was associated with urban location and fewer breast cancer patients. These results indicate that treatment of breast cancer is less than optimal at many small, urban hospitals that are poorly funded. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hospitals, Breast cancer

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Survival discriminants for differentiated thyroid cancer

Article Abstract:

The Illinois Division of the American Cancer Society has been publishing end-result information on cancer of major bodily sites. This data is obtained by voluntary submission of data by hospital cancer registries throughout the state. Pooled registry data makes information on large numbers of patients with long follow-up readily available. Thyroid cancer accounts for only about 1 percent of all cancers. An outcome analysis of this cancer is difficult because of its long history and the very low risk of dying from the disease. There were 2,282 patients newly diagnosed with thyroid cancer in Illinois between 1970 and 1984. Average follow-up was 6.5 years, with 880 patients being followed for at least 10 years. The information was analyzed for demographic-, disease- and treatment-related predictors of survival. Predictors for a favorable outcome after thyroid cancer were: early stage (stage I or stage II) disease; young age (under 50 years); white race, female; and postoperative use of either thyroid hormone or radioactive iodine. Factors that had no influence on survival included lymph node status, initial surgical treatment, and history of prior irradiation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Statistics, Tumors, American Cancer Society, Thyroid cancer

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Staging procedures, clinical management, and survival outcome for ovarian carcinoma

Article Abstract:

Women with stage III ovarian cancer who undergo both extensive surgery and platinum-based chemotherapy appear to have increased rates of survival. In the staging system of ovarian cancer, stages Ia and Ib are associated with the the highest survival rates and stage IV is associated with the lowest survival rates. Thirty percent of 632 patients in stage I, 31% of 233 patients in stage II and 45% of 516 patients in stage III underwent extensive surgery. Five-year survival rates of the stage I and II patients who underwent extensive surgery did not differ significantly from those who did not. Among patients with stage III cancer however, the five-year survival rate was 28% for women who underwent surgery and 21% for women who did not. Among 221 stage III patients who received chemotherapy, the survival rate was significantly higher for patients who received platinum-based chemotherapy than for those who received chemotherapy without platinum. Patients undergoing platinum-based chemotherapy were younger however, which may have contributed to their improved survival.

Surgery, Ovarian cancer, Chemotherapy

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