[Study of the diffusion of therapeutic progress in a morbidity register. Exemplified by rectal cancer in Calvados].

Recent treatment trends have been studied among 614 rectal cancer cases collected in the Digestive Tract Cancer Registry in the "Département" of Calvados between 1978 and 1986. Of the 343 cases in which the tumour was resected, the sphincter was preserved in 32% of the cases (SP), and 30% had adjuvant radiotherapy (ART). The frequency of sphincter preservation (SP) and ART increased significantly during the study period. For both SP and ART, generalized use was less frequent and implemented later in unspecialized health care centres, even after adjustment for confounding. SP was more widely used in females and younger patients. Starting in 1984, the generalized use of ART - especially in pre-operative therapy - developed considerably, particularly for males and younger patients. Distance from the radiotherapy centre did not influence the radiotherapy rate. The use of morbidity registry data in assessing health care practices gives us a more precise view than hospital series, and provides information that can be extremely useful for formulating future guidelines for health care planning.