A population perspective on the use of external beam radiotherapy in Catalonia, Spain
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RESEARCH ARTICLE
A population perspective on the use of external beam radiotherapy in Catalonia, Spain J. Corral1,2 · J. Solà1,2 · J. Galceran3,4 · R. Marcos‑Gragera5,6,7,8 · M. Carulla3,4 · Á. Izquierdo5,6,9 · L. Vilardell5,6 · L. Llauradó3 · J. A. Espinàs1,2 · J. M. Borras1,2,10 Received: 4 March 2020 / Accepted: 28 April 2020 © Federación de Sociedades Españolas de Oncología (FESEO) 2020
Abstract Purpose To assess the use of external beam radiotherapy in Catalonia (Spain), overall and by health management area. Methods We assessed radiotherapy treatments in a cohort of patients diagnosed with cancer from 2009 to 2011, using the population-based cancer registries in Girona and Tarragona. Participants had to have a minimum follow-up of 5 years from the time the cancer registry database was linked to the catalan health service database for financing radiation oncology. Outcomes included the proportion of patients receiving radiotherapy within 1 and 5 years of diagnosis. A log-binomial model was used to assess age-related trends in the use of radiotherapy by tumour site. Finally, we calculated the standardized utilization rate and 95% confidence intervals by health management area covered by the radiation oncology services, using indirect methods. Results At 1 and 5 years from diagnosis, 21.4 and 24.4% of patients, respectively, had received external beam radiotherapy. Patients aged 40–64 years had the most indications for the treatment, and there was a negative correlation between the patients’ age and the use of radiotherapy for most tumour sites (exceptions were cervical, thyroid, and uterine cancers). There were no statistically significant differences in the use of radiotherapy according to th health management area. Conclusions Population-based data show that external beam radiotherapy is underutilized in Catalonia. This situation requires a careful analysis to understand the causes, as well as an improvement of the available resources, oriented toward achieving realistic targets for the optimal use of external beam radiotherapy in our country. Keywords External beam radiotherapy · Access · Utilization · Cancer incidence · Cancer registry
Introduction Healthcare resource planning for therapies that involve costly investments, such as radiation oncology treatments, requires a needs assessment based on the best available evidence about therapeutic indications as well as an assessment * J. M. Borras [email protected] 1
Cancer Plan, Department of Health, Generalitat de Catalunya, Barcelona, Spain
2
Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
3
Tarragona Cancer Registry, Foundation League for Research Into the Prevention of Cancer (FUNCA), Reus, Spain
4
Pere Virgili Health Research Institute (IISPV), Reus, Spain
5
Epidemiology Unit and Girona Cancer Registry, Cancer Plan, Department of Health, Generalitat de Catalunya, Catalan Institute of Oncology, Girona, Spain
of the current real-world utilization of the treatment. This approach can elucidate potential gaps
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