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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 continuing to investigate international cancer survival differences and factors that might be causing this observed variation. ICBP researchers use a range of approaches to deliver high quality and policy-relevant evidence.

Our ongoing research focuses on the final topics of Phase 1 (‘Factors impacting short term survival outcomes’ and ‘Time intervals from symptom to treatment’) as well as our Phase 2 research agenda.

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

Differences in cancer registration practices:

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. The findings of this research will be published in early 2018.

The impact of comorbidities:

An international data linkage exercise was undertaken to investigate the extent to which comorbidities explain international cancer survival differences. The analysis brings together cancer registry, hospital admissions and clinical audit data for lung cancer patients to create measures of comorbidity and see if they can predict 1-year lung cancer survival. The findings, now published in Thorax, showed that it was possible to create measures of comorbidity from routine datasets which were predictive of survival in each jurisdiction. However, before these measures can be compared across jurisdictions, more needs to be done to ensure that the clinical coding used in datasets is comparable internationally.

Comorbidity scores for lung cancer patients (2017)

Differences in time intervals from first symptom until diagnosis and treatment between jurisdictions could affect the outcomes of patients with suspected cancer.

Using questionnaires sent to patient, primary care physician and cancer treatment specialists, the research team will report the first robust international comparison of time intervals from first symptom(s) until start of treatment.

The research team aim to provide new insights into:

  • Specific time intervals and details of a patient’s 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)

We expect the main findings of these papers to be published throughout 2018. The methods paper has already been published and can be found on our publication page.

The International Agency for Research on Cancer (IARC) will deliver an updated survival benchmark on lung, colon, rectal, ovarian, pancreatic, oesophageal, stomach and liver cancers.

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 (from ICBP Phase 1) which could inform methods for ensuring that robust international comparisons are feasible.

To find out more about this study, please visit the dedicated SURVMARK-2 pages on the IARC website.

Due to strong interest in further exploring our findings about primary care’s role in diagnosing cancer, the ICBP have begun to further investigate access to diagnostic and post-diagnostic tests. This research is being carried out by the ICBP Programme Management team, based at Cancer Research UK.

Currently, the project has finished its scoping and feasibility stage, and the team is working hard to deliver a research package that will further inform our partners of what data is available and which variables we will study. This process will ensure that the research we do is as interesting, relevant and robust as possible.

We’ll be updating this section of our webpages as outputs arise.

In the original cancer survival benchmark, exploring patients diagnosed between 1995 and 2007, differences in stage specific survival were seen. One reason for this difference internationally could be that patients who have the same cancer stage are being treated differently – and this is impacting their survival outcomes.

The research team based at Cancer Research UK is currently exploring what treatment data exists internationally and how guidelines for treatment compare across jurisdictions taking part.

We’ll be updating this section of our webpages as outputs arise.

In carrying out the Phase 1 research, it became clear that although ICBP partner jurisdictions are broadly comparable, there are more subtle differences that may be impacting on cancer survival outcomes.

As part of Phase 2, the partnership set out to increase our understanding of these differences. One element that will be focused on is the creation of cancer patient care pathways – these exist in most participating jurisdictions and set out how patients should be treated at each stage of their cancer journey. Our researchers will explore differences and similarities in the cancer patient journey and compare these to the pathways across jurisdictions.

The cancer patient care pathways work will be led by Professor Yoryos (Georgios) Lyratzopoulos at University College London and the structure of health system work will be led by Dr Ellen Nolte at The London School of Hygiene and Tropical Medicine.

We’ll be updating this section of our webpages as outputs arise.

The Phase 2 research agenda spans 2016 – 2020, but we expect there to be several outputs over the years. The below infographic shows the publication dates of previous ICBP research and the expected research from phase 2.​

Infographic showing the milestones of ICBP research

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