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SUMMARY:Why is cancer survival lower in England than in other high income 
 countries? - Sarah Walters &amp\; Sara Benitez Majano\, London School of H
 ygiene and Tropical Medicine
DTSTART:20181010T181500Z
DTEND:20181010T203000Z
UID:TALK102967@talks.cam.ac.uk
CONTACT:Peter Watson
DESCRIPTION:Background: Survival from cancer has historically been lower i
 n England than in comparable high income countries. We explore the trends 
 and drivers of this cancer survival deficit\, considering the extent to wh
 ich it is driven by differences in the timing of diagnosis and patient man
 agement.\n\nMethods: Using population-based data from national cancer regi
 stries in several high-income countries\, including England\, we estimated
  age-standardised net survival\, overall and by stage of disease for patie
 nts diagnosed with different cancers and during various timeframes up to t
 he year 2012. For colorectal cancer patients\, we also analysed internatio
 nal data on treatment using clinical audit data\, and assessed the extent 
 to which co-morbidity mediated differential treatment of patients by age a
 t diagnosis within England\, using mediation analysis. \n\nResults: Net su
 rvival was lower in England than in five comparable countries for four can
 cers. The gap in survival was especially large for patients diagnosed with
  later stage disease and at older ages. The stage distribution was similar
  between England and elsewhere suggesting the timing of diagnosis was simi
 lar between countries. Survival was lower in England for patients diagnose
 d at specific stages of disease\, indicating shortfalls in patient managem
 ent. Analysing treatment for colorectal cancer revealed that the proportio
 n of patients receiving radical surgery was lower in England than elsewher
 e\, even when controlling for age\, stage and (where possible) co-morbidit
 y. The colorectal cancer survival deficit in England was especially large 
 for older patients and\, within England\, age-related disparities in patie
 nt management were not mediated by co-morbidity. \n\nConclusion: Policies 
 should focus on improving stage-specific survival in England\, including i
 mproving the provision of treatment to the standards observed in comparabl
 e countries. The management of cancer in older patients in this country ne
 eds particular attention.
LOCATION:MRC Cognition and Brain Sciences Unit\, 15 Chaucer Road\, Cambrid
 ge CB2 7EF
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