Wieser Simon, Schmidt Marion, Kind André B, Heinzelmann-Schwarz Viola A
Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
Department of Gynaecology and Gynaecological Oncology, University Hospital Basel, University of Basel, Switzerland.
Swiss Med Wkly. 2018 Jul 29;148:w14647. doi: 10.4414/smw.2018.14647. eCollection 2018 Jul 16.
The methods used to diagnose and classify ovarian cancer have changed over the past decade. We used hospital registry data to assess the incidence, treatment durations and hospital costs of ovarian cancer in Switzerland.
We carried out a retrospective analysis of a hospital registry covering all inpatient care episodes in Switzerland between 1998 and 2012. Ovarian cancer incidence was assessed by identifying patients with a first ovarian cancer diagnosis as the main reason for hospital stay after an event-free period. We assessed the duration and cost of ovarian cancer treatment sequences as well as the evolution of hospital patient volume over time.
The average age-adjusted incidence rate was 14.6 per 100,000 women per year between 2004 and 2012. This rate is substantially higher (+35.5%) than the corresponding rate published by the National Institute for Cancer Epidemiology and Registration (NICER). Hospital patient volume was low in most cases, with more than 40% of patients treated in hospitals with fewer than 20 cases per year. However, the share of patients treated in hospitals with more than 30 cases per year has increased substantially since 2009.
We found a substantial difference between the ovarian cancer incidence estimate based on hospital registry data and the corresponding estimate by NICER. The reasons for this substantial difference should be carefully explored. A case-wise comparison could determine whether the difference is due to over- or under-reporting in one of the two registries. The low ovarian cancer patient volume in many hospitals is in conflict with the numbers required for certified specialised cancer centres. The recent increase in patient volume in specialised cancer centres, however, might reflect a growing understanding of the needs and requirements of comprehensive cancer care.
在过去十年中，用于诊断和分类卵巢癌的方法发生了变化。我们利用医院登记数据评估了瑞士卵巢癌的发病率、治疗时长和医院成本。
我们对一家涵盖1998年至2012年瑞士所有住院护理事件的医院登记处进行了回顾性分析。通过确定首次被诊断为卵巢癌的患者作为无事件期后住院的主要原因来评估卵巢癌发病率。我们评估了卵巢癌治疗序列的时长和成本以及医院患者数量随时间的变化。
2004年至2012年期间，年龄调整后的平均发病率为每年每10万名女性中有14.6例。该发病率比国家癌症流行病学和登记研究所（NICER）公布的相应发病率大幅高出（+35.5%）。大多数情况下医院的患者数量较少，超过40%的患者在每年收治病例少于20例的医院接受治疗。然而，自2009年以来，每年收治病例超过30例的医院中接受治疗的患者比例大幅增加。
我们发现基于医院登记数据的卵巢癌发病率估计与NICER的相应估计之间存在显著差异。应仔细探究这种显著差异的原因。逐例比较可以确定差异是否是由于两个登记处之一的报告过多或过少所致。许多医院中卵巢癌患者数量较少，这与认证专业癌症中心所需的数量相矛盾。然而，专业癌症中心近期患者数量的增加可能反映出对综合癌症护理需求和要求的认识不断提高。
