[Cancer treatment in Skane and in Sjaelland. Do differences concerning examination and treatment explain reduced survival among Danish cancer patients?].

INTRODUCTION

Danish cancer patients generally have a poorer survival than Swedish cancer patients. The difference is most pronounced for certain tumour types, e.g. common types such as lung, breast, colorectal, and prostate cancer. The reasons are not clear. The present article examines if differences in the diagnostic workup and treatment can explain some of this variation.

MATERIAL AND METHODS

Aspects of the diagnostic workup and treatment of the above mentioned four cancer types are examined using data from cancer registry analyses and official reports. These data are seen in the context of counts of trained personnel and equipment in cancer diagnostics and treatment in the two countries.

RESULTS

With regard to lung and breast cancer, the data seem to indicate that Danish patients are diagnosed later, and that Denmark lags behind in treatment capacity. With regard to rectal cancer, the data seem to indicate that concentrating operations in fewer hospitals, and improvements in operation technique have been introduced earlier in Sweden than in Denmark. With regard to prostate cancer, however, the data seem to indicate that many more indolent cases that do not need treatment are diagnosed in Sweden than in Denmark. The total capacity for oncologic treatment, both in terms of trained personnel and equipment, seen in relation to the size of the population, is considerably larger in Southern Sweden than in Eastern Denmark.

DISCUSSION

The data for some of the common cancer types seem to indicate that problems in the areas of sufficient capacity for diagnostic workup and treatment may explain some of the difference in survival between Danish and Swedish cancer patients.