ICBP research

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Our latest journal article

The development of questionnaires and recruitment to investigate milestones in diagnostic pathways.

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The ICBP is investigating international cancer survival differences and factors that might be causing observed variation. ICBP researchers use a range of methodologies and approaches to deliver high quality and policy-relevant findings.

Building on achievements to date, we are moving forward with ambitious plans to expand the scope of our research in phase 2 to:

  • Focus on 8 cancer sites across - lung, colon, rectal, ovarian, pancreatic, oesophageal, stomach and liver
  • Include 20 jurisdictions across 6 countries – Australia, Canada, Ireland, New Zealand, Norway and the UK.

ICBP research is focussed on a range of factors that may explain observed survival differences.

The greatest variations in the survival benchmark were for 1-year survival. Two possible explanations (among others) could be: 1) differences in cancer registration practices, and 2) the impact of co-morbidities (other health problems).

A key informant exercise was carried out with cancer registry contacts to better understand how cancer registries collect and process data. Using insights on how cancer registration practices differ, the impact of these differences have been estimated for 1-year survival calculations for breast, lung, colorectal and ovarian cancers.

An international data linkage exercise was undertaken to investigate the extent to comorbidities explain international cancer survival differences. The analysis will bring together cancer registry, hospital admissions and clinical audit data for lung cancer patients. 

Differences in time intervals from first symptom until diagnosis and treatment between jurisdictions could affect the outcomes of patients with suspected cancer. Using validated patient, primary care practitioner (PCP) and cancer treatment specialists (CTS) questionnaires the research team will report the first robust international comparison of time intervals from first symptom(s) until start of treatment.

By asking newly diagnosed patients (3-6 months after diagnosis), PCPs and CTSs about the patient’s journey from symptom onset until treatment, the research team aim to provide new insights into:

  • Specific time intervals and details of a patients route to diagnosis and treatment.
  • The number of times a patient saw a health care professional before diagnosis.
  • The nature of any referrals and diagnostic tests carried out.
  • Associations between these factors and a range of patient outcomes (including survival and stage at diagnosis).

Development of the international surveys sent to patients and their physicians

See samples of the survey sent to breast cancer patients, primary care practitioners and cancer treatment specialists in England.

Breast cancer patients

Primary care practitioners

Cancer treatment specialists

The International Agency for Research on Cancer (IARC) will deliver an updated survival benchmark on lung, colon, rectal, ovarian, pancreatic, oesophageal, stomach and liver cancer. Building on the previous benchmarking study, IARC will report a number of innovative metrics, such as:

  • Incidence, mortality and survival trends for 1995-2014 (1-, 5-, 10- and 15-year by stage, sex, age and morphology)
  • In-depth analysis of age-adjusted relative survival, avoidable deaths, excess mortality and issues associated with survivorship (e.g. reduction in life expectancy associated with a diagnosis of cancer)

IARC will also follow-up on initial findings about variations in cancer registration practices and coding frameworks which could inform methods for ensuring that robust international comparisons are feasible.

This updated survival benchmark will underpin further studies which aim to explore factors that may be driving international differences, including:

  • Access to diagnostics and investigations e.g. capacity, workforce, use, location, guidelines, value
  • Access to treatment and related factors e.g. specialisation, quality, innovation, uptake
  • Cancer patient care pathways e.g. standardised clinical pathways, typical costs, who pays
  • Structure of health systems e.g. role of clinicians, interface between primary and secondary care

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