"Cancer Treatment Policies, Delay in Referral and Their Effect on Survival"

This study makes use of the dataset on cancer treatment and referral patterns held by the Yorkshire Cancer Registry (YCR) and aims to evaluate, in systematic fashion, variation in treatment and referral delay and their effect on survival.

Specific objectives will be:

a)	to assess variation in treatment for 17 common cancers between 1986 and 1994 in the YCR catchment population (3 million) analysed by patient factors (age, deprivation status, tumour prognostic variables) and health service factors (health district, hospital, consultant workload and degree of consultant specialisation),
b)	to assess for the same cancers, variation in referrals times from GP’s to hospital and from initial hospital visit to first treatment, and
c)	to assess the impact of (a) and (b) on survival rates after adjustment for appropriate covariates.

Conference Presentations:

Cartman M.L., Round C.E., Rider L., Adamson P,. Forman D., Johnston C. Cancer Treatment Policies, Delay in Referral and Effect on Survival. International Association of Cancer Registries, 3-6 September 1996 Edinburgh

Publications:

NYCRIS Cancer outcomes monitoring: cancer treatment policies and their effects on survival (also at: http://www.nycris.org.uk/):

1. Central Nervous System  (Dec 1998)
2. Lung  (July 1999)
3. Melanoma  (Dec 1999)
4. Pancreas  (July 2000)
5. Colorectal  (Dec 2000)
6. Breast  (Dec 2001)
7. Cervix  (May 2002)
8. Ovary  (Dec 2002)

Cartman ML, Hatfield AC, Muers MF, Peake MD, Haward RA, Forman D on behalf of the Yorkshire Cancer Management Study Group. (2002) Lung cancer: district active treatment rates affect survival. Journal of Epidemiology and Community Health 56:424-8.

Stefoski-Mikeljevic J, Haward R, Johnston C, Sainsbury R, Forman D. (2003) Surgeon workload and survival from breast cancer.  British Journal of Cancer 89:487-91.

Stefoski-Mikeljevic J, Haward R, Johnston C, Crellin a, Dodwell D, Jones J, Pisani P, Forman D. (2004) Trends in postoperative radiotherapy delay and the effect on survival in breast cancer patients treated with conservation surgery. British Journal of Cancer 90:1343-48.

Haward RA, Morris E, Monson JRT, Johnston C, Forman D. (2005) The type of surgery affects the long term survival of rectal cancer patients: results of an observational study. European Journal of Surgical Oncology 31:22-28.

Downing A, Newton-Bishop JA, Forman D. (2006) Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003. British Journal of Cancer.  95:91-95.

Morris E, Haward RA, Gilthorpe MS, Craigs C, Forman D.  (2006) The impact of the Calman-Hine report on the processes and outcomes of care for Yorkshire ’s colorectal cancer patients. British Journal of Cancer. 95:979-85.

Morris E, Forman D, Haward RA (2007) The Impact of the Calman-Hine Report: Analysis of breast and colorectal cancer surgical workloads and the degree of surgical site specialisation in the Yorkshire region of the UK 1990-       2000.    European Journal of Cancer Care.  16:150-55.

Downing A, Haward RA, Stefoski-Mikeljevic J, Forman D. (2007) Variation in the treatment of cervical cancer patients and the effect of consultant workload on survival: a population-based study. European Journal of Cancer.  43:363-70.

Downing A, Prakash K, Gilthorpe MS, Stefoski-Mikeljevic J, Forman D. (2007) The effect of socioeconomic background on stage at diagnosis, treatment pattern and survival in women with invasive breast cancer. British Journal of Cancer. 96:836-40.

Further information can be obtained from:

Professor David Forman
Professor of Cancer Epidemiology
Centre for Cancer Research
University of Leeds
Arthington House
Cookridge Hospital
Leeds, LS16 6QB
UK