Mandy Kiderlen1, Antonio Ponti2, Mariano Tomatis2, Petra G Boelens3, Esther Bastiaannet1, Robin Wilson4, Cornelis J H van de Velde5, Riccardo A Audisio6. 1. European Registration of Cancer Care (EURECCA), Leiden, The Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Geriatrics and Gerontology, Leiden University medical Center, Leiden, The Netherlands. 2. European Society of Breast Cancer Specialists (EUSOMA), Italy; CPO Piemonte, AOU Città della Salute e della Scienza, Turin, Italy. 3. European Registration of Cancer Care (EURECCA), Leiden, The Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands. 4. European Society of Breast Cancer Specialists (EUSOMA), Italy; Department of Radiology, Royal Marsden Hospital, London, United Kingdom. 5. European Registration of Cancer Care (EURECCA), Leiden, The Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: c.j.h.van_de_velde@lumc.nl. 6. European Registration of Cancer Care (EURECCA), Leiden, The Netherlands; European Society of Breast Cancer Specialists (EUSOMA), Italy; Department of Surgery, St Helens Teaching Hospital, St Helens, United Kingdom; University of Liverpool, Liverpool, United Kingdom.
Abstract
OBJECTIVE: The aim of this study is to assess age-specific compliance to quality indicators (QIs) regarding the treatment of breast cancer as defined by European Society of Breast Cancer Specialists (EUSOMA) for patients across Europe. METHODS: All patients entered into this study were affected by in situ or invasive breast cancer, diagnosed and treated between 2003 and 2012 at 27 Breast Units across Europe, who were entered into the EUSOMA database. Patients were categorised according to age; compliance to thirteen QIs was assessed for each age group and per time period (2003-2007 and 2008-2012). Compliance to QIs was tested by multivariable logistic regression models adjusted for breast unit, incidence year and tumour characteristics. RESULTS: Overall, 41,871 patients with a mean age of 59.6years were available for analysis. The highest compliance was reached for patients aged 55-64years and in the time period 2008-2012, whilst the lowest compliance was observed for women aged over 74 or under 40years and in the earlier time period. In multivariable logistic regression models, a significant difference between age categories was shown for 12 out of 13 QIs (P<0.001). Compliance to the QIs for patients aged ⩾75years was significantly lower when compared to patients aged 55-64years for ten QIs, whilst for patients in the youngest age group this was true for seven QIs. CONCLUSION: In conclusion, we found that among the 27 included breast units across Europe, compliance to QIs for breast cancer treatment is often lower in the youngest and oldest breast cancer patients, with a tendency to overtreatment in the youngest patients, and to under-treatment in the elderly.
OBJECTIVE: The aim of this study is to assess age-specific compliance to quality indicators (QIs) regarding the treatment of breast cancer as defined by European Society of Breast Cancer Specialists (EUSOMA) for patients across Europe. METHODS: All patients entered into this study were affected by in situ or invasive breast cancer, diagnosed and treated between 2003 and 2012 at 27 Breast Units across Europe, who were entered into the EUSOMA database. Patients were categorised according to age; compliance to thirteen QIs was assessed for each age group and per time period (2003-2007 and 2008-2012). Compliance to QIs was tested by multivariable logistic regression models adjusted for breast unit, incidence year and tumour characteristics. RESULTS: Overall, 41,871 patients with a mean age of 59.6years were available for analysis. The highest compliance was reached for patients aged 55-64years and in the time period 2008-2012, whilst the lowest compliance was observed for women aged over 74 or under 40years and in the earlier time period. In multivariable logistic regression models, a significant difference between age categories was shown for 12 out of 13 QIs (P<0.001). Compliance to the QIs for patients aged ⩾75years was significantly lower when compared to patients aged 55-64years for ten QIs, whilst for patients in the youngest age group this was true for seven QIs. CONCLUSION: In conclusion, we found that among the 27 included breast units across Europe, compliance to QIs for breast cancer treatment is often lower in the youngest and oldest breast cancerpatients, with a tendency to overtreatment in the youngest patients, and to under-treatment in the elderly.
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