Keeping up with the Johansens.

Top Line: Where England and the Nordic countries are close geographically, they differ in their surgical management of colorectal cancer.
The Study: Who doesn’t love a nice neighborly comparison of cancer outcomes? In this study, a team of researchers sought to determine if differences in surgical management and survival exist among patients with colorectal cancer in England, Denmark, Sweden, and Norway. National cancer registries were pooled for patients treated between 2010 and 2012. Overall, 3 year survival was lower in England (64% colon, 70% rectum) and Denmark (66%, 73%) than in Sweden (72%, 74%) and Norway (70%, 75%). Broken down, these differences most clearly appeared in advanced stages. The authors found similar differences in the rates of patients who had surgical resection across countries: 68% in England → 81% in Sweden, at least suggesting an association with survival. In particular, 45-60% of patients over 75 years in England had surgery whereas 60-80% of those in Sweden had surgery. Of course there are huge caveats here. This is very big data—meaning it is difficult to look at the “whys” of treatment patterns.
Bottom Line: Trends in worse survival for patients with colorectal cancer in England compared to Nordic countries mirror trends in lower rates of surgical resection, particularly among older patients. | Benitez Majano, Lancet Oncol 2018


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