安大略省乳腺癌手术的差异。
Variation in breast cancer surgery in Ontario.
作者信息
Iscoe N A, Goel V, Wu K, Fehringer G, Holowaty E J, Naylor C D
机构信息
Toronto Bayview Regional Cancer Centre, Ont.
出版信息
CMAJ. 1994 Feb 1;150(3):345-52.
OBJECTIVES
To analyse the extent of variation by county and hospital in the use of breast-conserving surgery in the initial management of breast cancer and to assess some factors that might explain the observed variation.
DESIGN
Population-based retrospective cohort study.
SETTING
Ontario.
PATIENTS
All women with breast cancer newly diagnosed from Jan. 1, 1989, to Dec. 31, 1991.
MAIN OUTCOME MEASURE
Proportion of women undergoing unilateral breast cancer surgery who had breast-conserving surgery in each hospital and county.
RESULTS
Of the 14,570 women with newly diagnosed breast cancer 12,815 (88.0%) underwent unilateral breast cancer surgery. The mean proportion of breast-conserving procedures by county was 52% and ranged from 11% to 84%. The proportion of breast-conserving procedures in individual hospitals with one or more cases of breast cancer per month ranged from 6% to 84%. The variations in the rates between hospitals was greater than that expected by chance alone (p < 0.0001).
CONCLUSIONS
There was marked variation at the hospital and county level in the use of breast-conserving surgery in the initial management of breast cancer. This variation was strongly associated with the hospital where the surgery was performed.
目的
分析在乳腺癌初始治疗中保乳手术的使用在不同县和医院之间的差异程度，并评估一些可能解释所观察到差异的因素。
设计
基于人群的回顾性队列研究。
地点
安大略省。
患者
1989年1月1日至1991年12月31日新诊断出的所有乳腺癌女性患者。
主要观察指标
在每家医院及各县接受单侧乳腺癌手术且进行了保乳手术的女性比例。
结果
在14570例新诊断出乳腺癌的女性中，12815例（88.0%）接受了单侧乳腺癌手术。各县保乳手术的平均比例为52%，范围在11%至84%之间。每月有1例或更多例乳腺癌病例的各医院中，保乳手术的比例在6%至84%之间。医院之间的比例差异大于仅由偶然因素所预期的差异（p < 0.0001）。
结论
在乳腺癌初始治疗中，保乳手术的使用在医院和县级层面存在显著差异。这种差异与进行手术的医院密切相关。
Zotero 插件