Comparison of Model Estimates of Radiotherapy Needs With Utilization Data From British Columbia

Article Outline

• Purpose/Objective(s)
• Materials/Methods
• Results
• Conclusions
• Copyright

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Purpose/Objective(s) 

Estimates of the need for radiotherapy (RT) using different methods (Criterion based benchmarking–CBB, and Canadian (C), and Australian (A) Evidence Based Estimates (EBEST) for various cancer sites. EBEST models are based on indications from treatment guidelines and epidemiologic estimate of the proportion of cases with such indications. CBB estimates are actual rates of utilization in regions where use is assumed to be optimal. The CBB estimates relate to treatment rates at 1 year. The CEBEST models estimate rate for early (as part of initial therapy) and overall (at any time after diagnosis) RT, and the AEBEST estimates only overall rates of RT Our objective was to compare the actual rates of RT within 1 year and within 5 years of diagnosis in British Columbia to the CBB and EBEST model estimates for incident lung, prostate, breast, and all cancers combined. The province of BC is divided into 16 health districts. Four of these districts have cancer centres with RT facilities, each with responsibility to a region in the province consisting of various health districts.

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Materials/Methods 

We have identified all registered cases of cancer in BC in the years 1997 to 2004, with geographic region at diagnosis, date of diagnosis and cancer site. For each calendar year, we identified patients treated with RT at least once within 1 year and within 5 years of diagnosis. Patients were grouped according to cancer site and the health region at diagnosis, and the proportion of cases receiving RT within 1 and 5 years of diagnosis for health regions with a cancer centre for the most recent year were then calculated. RT rates were compared to published CBB and EBEST estimates of the need for RT.

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Results 

The 1 year RT rates in regions with a cancer centre for lung, breast, and prostate cancer were 51%, 58%, and 33% compared to 45%, 57%, and 32% for CEBEST and 41%, 61% and 37% for CBB models. The 5 years RT rates in regions with a cancer centre for lung, breast, prostate, and all cancers were 57%, 60%, 40% and 38% compared to 61%, 66%, 61%, and N/A for CEBEST (there is no CEBEST model for all cancers combined) and 76%, 83%, 60% and 52% for AEBEST models Figures for time trends over the years of the study will be shown graphically.

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Conclusions 

The actual RT rates in BC are close to the CEBST and CBB rates for some cancers sites, but lower than the AEBEST estimates for lung, breast, prostate and all cancer combined.