ArticleJournal of epidemiology and community health1999
Variation in the provision of chemotherapy for colorectal cancer.
Article in Journal of epidemiology and community health, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Pooled it
- Association Between Socioeconomic Status and Adherence to Fecal Occult Blood Tests in Colorectal Cancer Screening Programs: Systematic Review and Meta-Analysis of Observational Studies.JMIR public health and surveillance · 2023Pooled it
- Pooled it
- Influence of hospital type on survival in stage IV colorectal cancer.International journal of colorectal disease · 2016Article
- Access to specialist cancer care: is it equitable?British journal of cancer · 2002Article
- Impact of deprivation and rural residence on treatment of colorectal and lung cancer.British journal of cancer · 2002Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo quantify the impact of patient, area and hospital characteristics on variations in the provision of chemotherapy for colorectal cancer. SUBJECTS: Incident cases of colorectal cancer (ICD 153-154), aged under 75 years and resident in Scotland, derived from linked hospital discharge records and death records for the period January 1990 to June 1994. The final analysis was carried out on 7852 patients resident in 823 areas and first admitted to one of 59 hospitals.
main outcome measureWhether a patient received chemotherapy (OPCS4 procedure code X35.2) during any hospital episode in the six months after their first admission.
methodsMultilevel logistic regression to separate effects of patients, areas and hospitals.
resultsDuring the study period, 8% (n = 626) of the study population received chemotherapy within six months of their first admission. Adjusting for comorbidities and emergency admissions, both age and deprivation were significantly associated with the treatment. The odds ratios (OR) of chemotherapy relative to patients aged 65-74 were 2.13 and 4.50 for patients aged 55-64 and under 55 respectively. Relative to patients resident in the most affluent areas, the OR of chemotherapy for patients resident in the most deprived areas was 0.73. Area level availability of the treatment was not significantly associated with a patient's odds of receiving the treatment while on site provision of chemotherapy at the hospital of first admission was (OR = 4.32). There was significant unexplained variation between hospitals of first admission but not between areas of residence; between hospital variation decreased by 22% during the study period.
conclusionDifferences according to age may reflect both clinical and patient decisions regarding the benefits of the treatment relative to its toxicity. Lower treatment rates in deprived areas may indicate inequitable access to services. Hospital differences may reflect consultant effects and it would be expected that these should decrease now that the efficacy of the treatment has been recognised and guidelines have been issued.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.