Image: PD Normal Mammogram
1. New technological developments for five different cancers found not to impact mortality trends favorably
2. For cancers observed in this study, mortality trends decreased from 1970-2005 – most likely associated with overall improvements in healthcare
Evidence Rating Level: 2 (Good)
Study Rundown: With increasing healthcare costs associated with new technological diagnostic and therapeutic developments, many in government, as well as public health, are interested in determining the effects of these new technologies. This study sought to identify whether new innovations in cancer treatment have significantly improved mortality trends in seven European countries after their introduction between the years of 1970 and 2005.
Looking at treatment innovations developed for breast cancer, cervical cancer, testicular cancer, Hodgkin’s disease, and leukemia, researchers used joinpoint models to compare mortality trends before and after the introduction of the treatment and found there to be no significant changes in mortality associated with the introduction of the technology. In most cases, mortality trends were already decreasing and continued to decrease after the introduction of the technology. This observation led to the conclusion that overall improvements in healthcare during this time period were contributing to decreasing mortality. This study is large in scale across seven countries and over three decades, however researchers were unable to control for biases associated with overall natural improvements in healthcare and based on the data sets were unable to “differentiate between incidence, prevalence and mortality.”
In-Depth [retrospective literature study]: This study used data from Estonia, Spain, West Germany, The Netherlands, France, Sweden, and the UK to compare trends across national boundaries. For each cancer, researchers identified a specific intervention or therapeutic development and a range of time wherein that intervention was introduced to patients. The interventions identified for each cancer are the following:
Breast Cancer – mammographic screening and treatment with Tamoxifen
Cervical Cancer – Cervical screening
Testicular Cancer – Cisplatin treatment
Hodgkin’s Disease – High-dose therapy combined with peripheral blood stem cell transplantation
Leukemia – Overall improved treatment of disease process and complications
Researchers were looking specifically at the timing of the introduction of the therapies and how their introduction impacted mortality trends favorably. In each cancer there was an insignificant change in the mortality trend after introduction: breast cancer (p=.364), cervical cancer (p=.254), testicular cancer (p=.488), Hodgkin’s disease (p=.384), and leukemia (p=.396). The authors of the study were quick to comment that these results are not a reflection of the effectiveness of the treatment, but rather a look at how the introduction of the treatment impacted mortality in a positive manner.
By Jordan Anderson and Andrew Bishara
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