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Public health
Research
Exploring the added value of hospital-registry data for showing local service outcomes: cancers of the ovary, fallopian tube and peritoneum
  1. David Roder1,
  2. Margaret Davy2,
  3. Sid Selva-Nayagam3,
  4. Sellvakumaran Paramasivam4,
  5. Jacqui Adams5,
  6. Dorothy Keefe6,
  7. Caroline Miller7,8,
  8. Kate Powell7,9,
  9. Kellie Fusco1,
  10. Dianne Buranyi-Trevarton9,
  11. Martin K Oehler10
  1. 1 Cancer Epidemiology and Population Health, University of South Australia, Adelaide, South Australia, Australia
  2. 2 Private Consultant, Norwood, South Australia, Australia
  3. 3 Royal Adelaide Hospital Cancer Centre, Adelaide, South Australia, Australia
  4. 4 Flinders Medical Centre, Bedford Park, South Australia, Australia
  5. 5 Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
  6. 6 Citi Centre Hindmarsh Square Adelaide, Adelaide, South Australia, Australia
  7. 7 Population Health Research Group South Australian Health & Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
  8. 8 University of Adelaide, Adelaide, South Australia, Australia
  9. 9 SA Clinical Cancer Registry, SA Health, Adelaide, South Australia, Australia
  10. 10 Royal Adelaide Hospital, Adelaide, South Australia, Australia
  1. Correspondence to Professor David Roder; David.Roder{at}unisa.edu.au

Abstract

Objectives To explore the added value of hospital-registry data on invasive epithelial ovarian, tubal and peritoneal cancers.

Design Historic cohort analyses.

Methods Unadjusted and adjusted regression.

Setting Major South Australian hospitals.

Participants 1596 women (1984–2015 diagnoses).

Results 5-Year and 10-year survival was 48% and 41%, respectively, equivalent to relative survival for Australia and the USA. After adjusting for age, clinical and geographic factors, risk of ovarian cancer death was 25% lower in 2010–2015 than 1984–1989. Women generally had surgical treatment (87%) in their first round of care. This was more common for younger patients (adjusted OR (95% CIs) 0.17 (0.04 to 0.65) for 80+ vs <40 years) and earlier International Federation of Gynecology and Obstetrics stages (adjusted OR 0.48 (0.13 to 1.78) for stage IIIB/C and 0.13 (0.04 to 0.45) for stage IV vs stage IA). Most (74%) had systemic therapy, which was more common for advanced stages (adjusted ORs >15.0 for stages III and IV vs stage IA). Few (9%) had radiotherapy. Women generally had systemic therapy (74%), without difference by service accessibility and socioeconomic disadvantage, suggesting equity. However, surgery was less common for residents of the most compared with least remote areas (adjusted OR 0.49 (0.24 to 0.99)); and more common prior to adjustment in the highest versus lowest socioeconomic category (unadjusted OR 1.55 (1.01 to 2.39)), but this elevation did not apply after adjustment (adjusted OR 0.19 (0.63 to 2.25)), with the difference largely explained by stage.

Conclusions Hospital-registry data add value for assessing local service delivery. Equivalent survival to Australia-wide and USA survival, and temporal gains after adjusting for stage and other patient characteristics are reassuring. Survival gains may reflect therapeutic benefits of more extensive surgery and improved chemotherapy regimens.

  • cancer registries
  • treatment and survival

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-024036

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    Footnotes

    • Patient consent for publication Not required.

    • Contributors All authors contributed to the study conception, design and interpretation of the data. Data acquisition: KP, KF, DBT; quality control of data and algorithms: DR; data and statistical analysis: DR, KF; interpretation of historic data coding: MD; gynaecological oncology expertise: MD, MO; medical oncology expertise: SS-N, SP, JA, DK; health administration expertise: DK; population health expertise: CM; cancer registry science expertise: KP, DB-T; data management: KF; epidemiology expertise: DR, KF; manuscript preparation: DR, MO. All authors contributed to the editing and review of the manuscript and approved the version to be published and agreed to be accountable for the work.

    • Funding This study received funding support from Cancer Council SA (Beat Cancer Project), South Australian Health and Medical Research Institute, University of South Australia and the South Australian Department of Health.

    • Competing interests None declared.

    • Ethics approval Research ethics approval for this study was provided by the South Australian Department for Health and Ageing Human Research Ethics Committee (reference number: LNR HREC/17/SAH/2).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Direct access to the data and analytical files is not permitted without the expressed permission of the approving human research ethics committees and data custodians. Researchers interested in collaboration should contact the corresponding author with their expression of interest.