In 1999, the Department of Health (DH) produced good-practice guidance on commissioning cancer services for gynaecology, entitled Improving Outcomes in Gynaecological Cancer. The new guidance called for a reorganisation of services, working in multidisciplinary teams and a concentration of surgical expertise in centres.
In addition, in 2000 the DH published referral guidance for primary care for symptoms that were suggestive of cancer (the 2-week wait initiative). Hospital providers were expected to respond to the referral in a timely fashion, with a target of 2 weeks between the date of referral and the first appointment. It was hoped this would improve outcomes and address the variation in access to diagnosis and treatment.
In the Anglia Cancer Network (Bedfordshire, Cambridgeshire, Norfolk and Suffolk), the guidance was implemented by the year 2000, with the centralisation of care predominantly shifting to Addenbrookes Hospital, serving a population of 1.5 million and the Norfolk and Norwich Hospital serving a population of 850,000.
This paper looks at 3406 cases of invasive gynaecological cancer between 1996 and 2003 in this area. Sixty percent of the cases had known tumour stage and grade and the majority of cases relate to endometrial and ovarian cancer (77.4%).
The study found that the survival of cancers diagnosed between 1997 and 1999 was effectively identical to the survival of cancers diagnosed in the baseline year, 1996. Survival of cases diagnosed between 2000 and 2003 increased significantly: Overall 17% improvement; uterine cancer improved by nearly 10% (9.5) to 83% and ovarian cancer improved by 45% to nearly 40% when compared with cancers diagnosed in the four earlier years. These changes have been most significant within endometrial and ovarian cancers.
Dr Robin Crawford, Consultant Gynaecological Oncologist, Addenbrookes Hospital, Cambridge, and co-author of the paper said:
"The data shows that there has been a significant increase in survival of gynaecological cancers over the time period reviewed.
"In addition to the minor year-on-year improvements, there was a significant stepwise improvement in survival in 2000, following the major reorganisation in the region.
"Centralising services and working in multidisciplinary teams has been shown to improve patient care significantly and most importantly survival rates.
"Further work is being undertaken to ensure that these improvements are continued."
BJOG Deputy Editor-in-Chief, Pierre Martin-Hirsch, added:
"It is exciting to see such promising results. This cancer network implemented new policies very promptly and as a result there has been a significant improvement in the gynaecological cancer survival rates.
"This paper confirms the findings in a recent Macmillan report based on research from the Cancer Research UK Cancer Survival Group at the London School of Hygiene and Tropical Medicine demonstrating improved survival times for women with cancer. Cancer patients are surviving for longer and an example of new initiatives aiding this is the work being undertaken in the Anglia region."
The BJOG theme issue focuses on gynaecological oncology with papers looking at cervical cancer prevention, as well as new developments in cervical and ovarian cancer management.
BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Wiley-Blackwell. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote 'BJOG' or 'BJOG: An International Journal of Obstetrics and Gynaecology' when referring to the journal and include the website: www.bjog.org as a hidden link online.
Reference: Crawford R, Greenberg D. Improvements in survival of gynaecological cancer in the Anglia region of England: are these an effect of centralisation of care and use of multidisciplinary management? BJOG 2011; DOI: 10.1111/j.1471-0528.2011.02961.x.
Amy Molnar | EurekAlert!
Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung
High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg
Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.
"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...
In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.
A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...
By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.
"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...
COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.
In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...
'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.
Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...
14.10.2016 | Event News
14.10.2016 | Event News
12.10.2016 | Event News
21.10.2016 | Health and Medicine
21.10.2016 | Information Technology
21.10.2016 | Materials Sciences