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Use of Population Stage Data
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guideline concordance - - PowerPoint PPT Presentation
guideline concordance - - PowerPoint PPT Presentation
Using population bases staging data to inform cancer resource allocation cancer screening and treatment guideline concordance
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SLIDE 3
ONTARIO 13 Million Larger than France and Spain Combined
The Stage- Path Project provides a rich dataset
- f cancer
information for Ontario
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Stage Project goal is to expand to population based stage data capture
- - 33% stage capture
Baseline (2007)
Ontario
Actual (2008)
- - 47% stage capture
- - 74% stage capture
90% of all cancer cases are staged Target (2009) Final Target
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90% of Ontario pathology reports completed in January 2011, were synoptic
5 !
- January 2011
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Stage Distribution, Breast, Colorectal, Lung, Prostate Cancer 2008
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Indicators for screening
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20% Colorectal Cancer IV
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75% Lung Cancer III or IV
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Indicators for resourses
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Lung Cancer by Region The distribution of stage IV cancer ranges from 43% to 54%
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Stage Distribution and Regional Variation
- The health care needs of the region for
treatment costs, palliative care costs may be higher in regions were there is more stage IV cancer than others
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Indicators for resection rates by stage
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Region Variation in treatment - Surgery
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Region Variation in treatment - Surgery
- The rate of surgical resection in non small
cell lung cancer in Ontario varies from 13% to 28%
- This could be explained by more early
cases in the LHIN with the higher rate
- Linking surgical treatment to stage show
that in one region 54% of stage I patients have surgery compared to 78% in another LHIN
- Other explanations must be looked for
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Indicators of treatment rates by stage
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The percentage of stage II and IIIA resected cell lung cancer treated with chemotherapy or radiation therapy or both
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Regional Variation in Treatment Guideline Concordance
- Ontario has a mature program in
Evidence-Based Care
- Adjuvant platinum based chemotherapy is
recommended in completely resected stage II and III non small cell lung cancer
- Compliance overall is 56% but varies from
32-66%
- The reasons for this can be investigated
and further physician education is required
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Indicators of survival rates by stage
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The one year relative survival by stage at diagnosis by LHIN and Ontario for non small cell lung cancer
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Regional Variation in Survival
- Survival by stage and region can be
determined
- One year survival in patients with stage IV
cancer varies by region from 15%- 31%
- Reasons for this require further
investigation
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Conclusions
- Adding stage data to other data collected
by a cancer program greatly enhances that data
- It can be used to measure the
effectiveness of screening programs, determine health care needs by region and determine variations in treatment practice
- Further communication and investigation
- f data quality and clinical practice is