Better ascertainment of cancer cases may lead to reduced survival

Comparisons between centres and countries in survival from cancer are putting the spotlight on cancer services. On p 214 Stotter et al show, however, that one effect of improved ascertainment may be to increase the incidence of cancer and, counterintuitively, to reduce survival. They compared cases of breast cancer reported to the Trent cancer registry and a clinical database at one hospital. The registry listed 535 cancers in 1997; adding cases from the hospital database brought the number to 599, a 12% increase. All 12 patients receiving private care were missed by the registry. In general those patients missed by the registry were older with shorter survivals, so adding them had the effect of reducing five year survival from 62% to 59%.

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Effect of improved data collection on breast cancer incidence and survival: reconciliation of a registry with a clinical database

Anne Stotter, Nicola Bright, Paul B Silcocks, and Johannes L Botha
BMJ 2000 321: 214. [Full Text] [PDF]