The basic scope of population-based cancer registries (CRs) is to collect data that enable computation of cancer incidence. In addition to this, nowadays most registries can provide more extensive information such as data on stage and treatment, which could be used to assess and compare different care pathways. The current analysis reports on treatment by stage patterns for female breast cancer in Europe.
Data from CRs included in the European Cancer Information System (ECIS) and having submitted data on stage and treatment for the ENCR-JRC project were analysed. Proportion of cases by treatment type: surgery (SG), radiotherapy (RT), systemic therapy (ST), by stage, age, period and region were calculated.
829,247 cases from 20 CRs were analysed. Treatment for stage I (UICC TNM) patients aged 19-74 in 1999-2005 was SG alone (22%), SG+ST (13%) SG+RT (31%), SG+RT+ST (32%). SG alone decreased to 18%, while SG+RT+ST rose to 37% in 2006-13. High variability was observed: in Eastern Europe SG alone was 31%, SG+ST 17%, SG+RT 24%, SG+RT+ST 23% in 2006-13, in Western Europe SG alone was 12%, SG+ST 13%, SG+RT 31%, SG+RT+ST 43%. For age 75+ in 1999-2005 SG (37%) and SG+ST (20%) were higher than in 19-74 patients, while SG+RT (17%) and SG+RT+SG (15%) were lower. SG decreased to 31%, SG+RT+ST rose to 20% in 2006-13. Untreated patients were 3% in both periods. For the regional comparison, in 2006-13 SG alone was 50% in Eastern Europe vs 25% in Western Europe; SG+RT+ST was 9% in Eastern Europe, 24% in Western Europe. In 2006-13 for younger stage IV patients SG alone was 7%, ST alone 29%, SG+ST 18%, SG+RT+ST 14%, no treatment 9%. For 75+ patients SG was 11%, ST 30%, SG+ST 12%, SG+RT+ST 7%, no treatment 15%.
Variability in treatment patterns was observed by stage, age, period and region. Clinical information from CRs should be routinely used to monitor clinical care patterns, according to national and international recommendations, to compare levels of compliance and inform policy.
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All authors have declared no conflicts of interest.