Optimal uptake rates for initial treatments for cervical cancer in

Optimal uptake rates for initial
treatments for cervical cancer in
concordance with guidelines in Australia
and Canada
Decision analytical modelling using patterns of care study data
Dr Yoon-Jung Kang
Abstract ID 373
Track
Prevention and screening
Disclosure of Interest: None Declared
www.worldcancercongress.org
Optimal uptake rates for initial treatments for cervical cancer in concordance with guidelines in Australia and Canada
Dr Yoon-Jung Kang
Optimal treatment rates for cervical cancer
Optimal treatment rate = β€‹π‘ƒπ‘Žπ‘‘π‘–π‘’π‘›π‘‘π‘  π‘€π‘–π‘‘β„Ž π‘‘π‘–π‘ π‘’π‘Žπ‘ π‘’ 𝐴 π‘Ÿπ‘’π‘π‘’π‘–π‘£π‘–π‘›π‘” π‘‘π‘Ÿπ‘’π‘Žπ‘‘π‘šπ‘’π‘›π‘‘ 𝑋 /𝐴𝑙𝑙 π‘π‘Žπ‘‘π‘–π‘’π‘›π‘‘π‘  π‘€π‘–π‘‘β„Ž β€’β€―
β€’β€―
π‘‘π‘–π‘ π‘’π‘Žπ‘ π‘’
𝐴 (surgery or radiotherapy); FIGO IIB-IVB (radiotherapy, chemo-radiotherapy, or chemotherapy); co-morbidities
FIGO IA-IIA
β€’β€―
Data sources: the Royal Hospital for Women, Australia (year 1999-2008); CancerCare Manitoba, Canada (year 1999-2008)
β€’β€―
Model structure: recommended treatment (treatment guidelines) and other treatments (patterns of care) for FIGO sub-stage
β€’β€―
Model inputs: proportions of patients with key clinical indicators (FIGO stage distribution, performance status and etc.)
Optimal treatment rates
80%
70%
70%
60%
50%
40%
30%
20%
72% 54%
28% 46%
10%
0%
% cervical cancer patients
% cervical cancer patients
FIGO stage distribution at diagnosis (1999-­β€2008)
80%
Higher in Canada (i.e. more advanced stage disease) 60%
50%
40%
30%
20%
10%
0%
Australia
Canada
FIGO IA-­β€IIA
Australia
Canada
FIGO IIB-­β€IVB
Aus
Can
Surgery
Aus
Can
Radiotherapy
Aus
Can
Chemotherapy
Aus
Can
Chemo-­β€radiotherapy
Abstract ID 373. Disclosure of interests for presenting author: None
Optimal uptake rates for initial treatments for cervical cancer in concordance with guidelines in Australia and Canada
Dr Yoon-Jung Kang
Radiotherapy and chemo-radiotherapy rates
Chemo-­β€radiotherapy
Radiotherapy
50%
Over 40%
30%
20%
10%
0%
-­β€10%
-­β€20%
~20% -­β€30%
-­β€40%
Under (baseline) ~5% under-­β€u>lised Difference (observed -­β€ optimal)
Difference (observed -­β€ optimal)
50%
40%
30%
20%
10%
0%
-­β€10%
-­β€20%
-­β€30%
-­β€40%
~44% ~15% under-­β€u>lised (baseline) -­β€50%
-­β€50%
Aus
Can
Overall
Aus
IA1
Can
Aus
IA2
Can
Aus
Can
IB-­β€IIA
Aus
Can
IIB-­β€IVA
Aus
Can
IVB
Aus
Can
Overall
Aus
IA1
Can
Aus
IA2
Can
Aus
Can
Aus
IB-­β€IIA
Can
IIB-­β€IVA
Aus
Can
IVB
Vertical lines indicate the range within which 95% of the estimates fell from the probabilistic sensitivity analysis involving a total of 3000 scenarios (i.e. 95% credible interval)
Conclusion
β€’β€― Optimal treatment rates are largely dependent on the overall stage distribution at diagnosis
β€’β€― Radiotherapy and chemo-radiotherapy are under-utilised (especially in FIGO stage IIB-IVB disease)
β€’β€― Assist health services planning
Abstract ID 373. Disclosure of interests for presenting author: None