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Brettschneider J, Morrison B, Jenkinson D, Freeman K, Walton J, Sitch A, Hudson S, Kearins O, Mansbridge A, Pinder SE, Given-Wilson R, Wilkinson L, Wallis MG, Cheung S, Taylor-Phillips S. Development and quality appraisal of a new English breast screening linked data set as part of the age, test threshold, and frequency of mammography screening (ATHENA-M) study. Br J Radiol 2024; 97:98-112. [PMID: 38263823 PMCID: PMC11027252 DOI: 10.1093/bjr/tqad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVES To build a data set capturing the whole breast cancer screening journey from individual breast cancer screening records to outcomes and assess data quality. METHODS Routine screening records (invitation, attendance, test results) from all 79 English NHS breast screening centres between January 1, 1988 and March 31, 2018 were linked to cancer registry (cancer characteristics and treatment) and national mortality data. Data quality was assessed using comparability, validity, timeliness, and completeness. RESULTS Screening records were extracted from 76/79 English breast screening centres, 3/79 were not possible due to software issues. Data linkage was successful from 1997 after introduction of a universal identifier for women (NHS number). Prior to 1997 outcome data are incomplete due to linkage issues, reducing validity. Between January 1, 1997 and March 31, 2018, a total of 11 262 730 women were offered screening of whom 9 371 973 attended at least one appointment, with 139 million person-years of follow-up (a median of 12.4 person years for each woman included) with 73 810 breast cancer deaths and 1 111 139 any-cause deaths. Comparability to reference data sets and internal validity were demonstrated. Data completeness was high for core screening variables (>99%) and main cancer outcomes (>95%). CONCLUSIONS The ATHENA-M project has created a large high-quality and representative data set of individual women's screening trajectories and outcomes in England from 1997 to 2018, data before 1997 are lower quality. ADVANCES IN KNOWLEDGE This is the most complete data set of English breast screening records and outcomes constructed to date, which can be used to evaluate and optimize screening.
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Affiliation(s)
- Julia Brettschneider
- Department of Statistics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Breanna Morrison
- University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - David Jenkinson
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Karoline Freeman
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Jackie Walton
- Screening Quality Assurance Service, NHS England, Birmingham, B2 4BH, United Kingdom
| | - Alice Sitch
- University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - Sue Hudson
- Peel & Schriek Consulting Ltd, London, NW3 4QG, United Kingdom
| | - Olive Kearins
- Screening Quality Assurance Service, NHS England, Birmingham, B2 4BH, United Kingdom
| | - Alice Mansbridge
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Sarah E Pinder
- School of Cancer & Pharmaceutical Sciences, King's College London, London, WC2R 2LS, United Kingdom
- Comprehensive Cancer Centre at Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, United Kingdom
| | - Rosalind Given-Wilson
- St George's University Hospitals NHS Foundation Trust, London, SW17 0QT, United Kingdom
| | - Louise Wilkinson
- Oxford Breast Imaging Centre, Churchill Hospital, Oxford, OX3 7LE, United Kingdom
| | - Matthew G Wallis
- Cambridge Breast Unit and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Trust, Cambridge, CB2 0QQ, United Kingdom
| | - Shan Cheung
- Screening Quality Assurance Service, NHS England, Birmingham, B2 4BH, United Kingdom
| | - Sian Taylor-Phillips
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
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Chen JG, Chen HZ, Zhu J, Shen AG, Sun XY, Parkin DM. Cancer survival: left truncation and comparison of results from hospital-based cancer registry and population-based cancer registry. Front Oncol 2023; 13:1173828. [PMID: 37350938 PMCID: PMC10284078 DOI: 10.3389/fonc.2023.1173828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/16/2023] [Indexed: 06/24/2023] Open
Abstract
Background Cancer survival is an important indicator for evaluating cancer prognosis and cancer care outcomes. The incidence dates used in calculating survival differ between population-based registries and hospital-based registries. Studies examining the effects of the left truncation of incidence dates and delayed reporting on survival estimates are scarce in real-world applications. Methods Cancer cases hospitalized at Nantong Tumor Hospital during the years 2002-2017 were traced with their records registered in the Qidong Cancer Registry. Survival was calculated using the life table method for cancer patients with the first visit dates recorded in the hospital-based cancer registry (HBR) as the diagnosis date (OSH), those with the registered dates of population-based cancer (PBR) registered as the incidence date (OSP), and those with corrected dates when the delayed report dates were calibrated (OSC). Results Among 2,636 cases, 1,307 had incidence dates registered in PBR prior to the diagnosis dates of the first hospitalization registered in HBR, while 667 cases with incidence dates registered in PBR were later than the diagnosis dates registered in HBR. The 5-year OSH, OSP, and OSC were 36.1%, 37.4%, and 39.0%, respectively. The "lost" proportion of 5-year survival due to the left truncation for HBR data was estimated to be between 3.5% and 7.4%, and the "delayed-report" proportion of 5-year survival for PBR data was found to be 4.1%. Conclusion Left truncation of survival in HBR cases was demonstrated. The pseudo-left truncation in PBR should be reduced by controlling delayed reporting and maximizing completeness. Our study provides practical references and suggestions for evaluating the survival of cancer patients with HBR and PBR.
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Affiliation(s)
- Jian-Guo Chen
- Department of Epidemiology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
- Department of Epidemiology, Qidong Liver Cancer Institute, Qidong People’s Hospital, Affiliated Qidong Hospital of Nantong University, Qidong, China
| | - Hai-Zhen Chen
- Department of Epidemiology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Jian Zhu
- Department of Epidemiology, Qidong Liver Cancer Institute, Qidong People’s Hospital, Affiliated Qidong Hospital of Nantong University, Qidong, China
| | - Ai-Guo Shen
- Department of Epidemiology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Xiang-Yang Sun
- Department of Epidemiology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Donald Maxwell Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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Li X, Tan B, Zheng J, Xu X, Xiao J, Liu Y. The Intervention of Data Mining in the Allocation Efficiency of Multiple Intelligent Devices in Intelligent Pharmacy. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:5371575. [PMID: 36045963 PMCID: PMC9423971 DOI: 10.1155/2022/5371575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/20/2022] [Accepted: 07/29/2022] [Indexed: 02/05/2023]
Abstract
With the wide application of artificial intelligence and big data technology in the medical field, the problems of high cost and low efficiency of traditional pharmacy management were becoming more and more obvious. Therefore, this paper proposed to use data mining technology to design and develop the dispensing process and equipment of intelligent pharmacy. Firstly, it summarized the existing data mining technology and association rule methods and expounded its application value in the related fields. Secondly, the data standard and integration platform of dispensing in intelligent pharmacy were established. Web service technology was used to design the interactive interface and call it to the intelligent device of pharmacy. Finally, an intelligent pharmacy management system based on association rule mining was constructed through the data mining of intelligent pharmacy equipment, in order to improve the intelligence and informatization of modern pharmacy management. For the emergency dispensing process of intelligent equipment failure, data mining was used to optimize the intelligent pharmacy equipment and dispensing process and change the pharmacy management from traditional prescription to patient drug treatment, so as to improve the dispensing efficiency of intelligent pharmacy equipment. Through the systematic test and analysis, the results showed that through the real-time risk prevention and control, the formula accuracy and operation speed of the intelligent dispensing machine were improved and the dispensing time was shortened. Through intelligent drug delivery, the unreasonable drug use of patients was reduced, the safety and effectiveness of clinical drug use were ensured, and the contradiction between doctors and patients was reduced. This study can not only optimize the medical experience of patients and provide patients with more high-quality and humanized pharmaceutical technical services but also provide some support for the intelligent management of modern hospitals.
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Affiliation(s)
- Xiaohua Li
- The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan 512026, Guangdong, China
| | - Benren Tan
- The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan 512026, Guangdong, China
| | - Jinkun Zheng
- The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan 512026, Guangdong, China
| | - Xiaomei Xu
- The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan 512026, Guangdong, China
| | - Jian Xiao
- The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan 512026, Guangdong, China
| | - Yanlin Liu
- The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan 512026, Guangdong, China
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Conway C, Collins DM, McCann A, Dean K. Research Strategies for Low-Survival Cancers. Cancers (Basel) 2021; 13:528. [PMID: 33573275 PMCID: PMC7866553 DOI: 10.3390/cancers13030528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
While substantial progress has been made to improve the diagnosis, prognosis, and survivorship of patients with cancer, certain cancer types, along with metastatic and refractory disease, remain clinical challenges. To improve patient outcomes, ultimately, the cancer research community must meet and overcome these challenges, leading to improved approaches to treat the most difficult cancers. Here, we discuss research progress aimed at gaining a better understanding of the molecular and cellular changes in tumor cells and the surrounding stroma, presented at the 56th Irish Association for Cancer Research (IACR) Annual Conference. With a focus on poor prognosis cancers, such as esophageal and chemo-resistant colorectal cancers, we highlight how detailed molecular knowledge of tumor and stromal biology can provide windows of opportunity for biomarker discovery and therapeutic targets. Even with previously characterized targets, such as phosphoinositide 3-kinase (PI3K), one of the most altered proteins in all human cancers, new insights into how this protein may be more effectively inhibited through novel combination therapies is presented.
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Affiliation(s)
- Caroline Conway
- Genomics Core Facility, Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, UK;
| | - Denis M. Collins
- National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland;
| | - Amanda McCann
- UCD Conway Institute of Biomolecular and Biomedical Research and UCD School of Medicine College of Health and Agricultural Science (CHAS), University College Dublin, Belfield, Dublin 4, Ireland;
| | - Kellie Dean
- School of Biochemistry and Cell Biology, 3.91 Western Gateway Building, University College Cork, Cork T12 XF62, Ireland
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Koo MM, Unger-Saldaña K, Mwaka AD, Corbex M, Ginsburg O, Walter FM, Calanzani N, Moodley J, Rubin GP, Lyratzopoulos G. Conceptual Framework to Guide Early Diagnosis Programs for Symptomatic Cancer as Part of Global Cancer Control. JCO Glob Oncol 2021; 7:35-45. [PMID: 33405957 PMCID: PMC8081530 DOI: 10.1200/go.20.00310] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/06/2020] [Accepted: 11/06/2020] [Indexed: 12/15/2022] Open
Abstract
Diagnosing cancer earlier can enable timely treatment and optimize outcomes. Worldwide, national cancer control plans increasingly encompass early diagnosis programs for symptomatic patients, commonly comprising awareness campaigns to encourage prompt help-seeking for possible cancer symptoms and health system policies to support prompt diagnostic assessment and access to treatment. By their nature, early diagnosis programs involve complex public health interventions aiming to address unmet health needs by acting on patient, clinical, and system factors. However, there is uncertainty regarding how to optimize the design and evaluation of such interventions. We propose that decisions about early diagnosis programs should consider four interrelated components: first, the conduct of a needs assessment (based on cancer-site-specific statistics) to identify the cancers that may benefit most from early diagnosis in the target population; second, the consideration of symptom epidemiology to inform prioritization within an intervention; third, the identification of factors influencing prompt help-seeking at individual and system level to support the design and evaluation of interventions; and finally, the evaluation of factors influencing the health systems' capacity to promptly assess patients. This conceptual framework can be used by public health researchers and policy makers to identify the greatest evidence gaps and guide the design and evaluation of local early diagnosis programs as part of broader cancer control strategies.
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Affiliation(s)
- Minjoung Monica Koo
- Epidemiology of Cancer Healthcare and Outcomes (ECHO) Research Group, Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Karla Unger-Saldaña
- CONACYT (National Council of Science and Technology)–National Cancer Institute, Mexico City, Mexico
| | - Amos D. Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Ophira Ginsburg
- Perlmutter Cancer Center and the Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY
| | - Fiona M. Walter
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Natalia Calanzani
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jennifer Moodley
- Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- SAMRC Gynaecology Cancer Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Greg P. Rubin
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare and Outcomes (ECHO) Research Group, Department of Behavioural Science and Health, University College London, London, United Kingdom
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Jansen L, Schröder CC, Emrich K, Holleczek B, Pritzkuleit R, Brenner H. Disclosing progress in cancer survival with less delay. Int J Cancer 2020; 147:838-846. [PMID: 31785152 DOI: 10.1002/ijc.32816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/31/2019] [Accepted: 11/18/2019] [Indexed: 11/08/2022]
Abstract
Cancer registration plays a key role in monitoring the burden of cancer. However, cancer registry (CR) data are usually made available with substantial delay to ensure best possible completeness of case ascertainment. Here, we investigate empirically with routinely available data whether such a delay is mandatory for survival analyses or whether data can be used earlier to provide more up-to-date survival estimates. We compared distributions of prognostic factors and period relative survival estimates for three population-based CRs in Germany (Schleswig-Holstein (SH), Rhineland-Palatinate (RP), Saarland (SA)) computed on datasets extracted one (DY+1) to 5 years after the year of diagnosis (DY+5; reference). Analyses were conducted for seven cancer sites and various survival analyses scenarios. The proportion of patients registered in the datasets at a given time varied strongly across registries with 57% (SH), 2% (RP) and 26% (SA) registered in DY+1 and >93% in all registries in DY+3. Five-year survival estimates for the most recent three-year period were comparable to estimates from the reference dataset already in DY+1 (mean absolute deviations = 0.2-0.6% units). Deviations >1% units were only observed for pancreatic and lung cancer in RP and leukemia in SA (all ≤1.5% units). For estimates of 1-year survival based on the most recent 1-year period only, slightly longer delays were required, but reasonable estimates were still obtained after 1-2 years, depending on the CR and cancer site. Thus, progress in cancer survival could be disclosed in a more timely manner than commonly practiced despite delays in completeness of registration.
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Affiliation(s)
- Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Chloé C Schröder
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katharina Emrich
- Cancer Registry of Rhineland-Palatinate, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center, Heidelberg, Germany
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7
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Wanner M, Matthes KL, Korol D, Dehler S, Rohrmann S. Indicators of Data Quality at the Cancer Registry Zurich and Zug in Switzerland. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7656197. [PMID: 30009174 PMCID: PMC6020656 DOI: 10.1155/2018/7656197] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/10/2018] [Indexed: 11/17/2022]
Abstract
Data quality is an important issue in cancer registration. This paper provides a comprehensive overview of the four main data quality indicators (comparability, validity, timeliness, and completeness) for the Cancer Registry Zurich and Zug (Switzerland). We extracted all malignant cancer cases (excluding non-melanoma skin cancer) diagnosed between 1980 and 2014 in the canton of Zurich. Methods included the proportion of morphologically verified cases (MV%), the proportion of DCN and DCO cases (2009-2014), cases with primary site uncertain (PSU%), the stability of incidence rates over time, age-specific incidence rates for childhood cancer, and mortality:incidence (MI) ratios. The DCO rate decreased from 6.4% in 1997 to 0.8% in 2014 and was <5% since 2000. MV% was 95.5% in 2014. PSU% was <3% over the whole period. The incidence rate of all tumours increased over time with site-specific fluctuations. The overall M:I ratio decreased from 0.58 in 1980 to 0.37 in 2014. Overall, data quality of the Cancer Registry Zurich and Zug was acceptable according to the methods presented in this review. Most indicators improved over time with low DCO rates, high MV%, low PSU%, relatively low M:I ratios and age-specific incidence of childhood cancer within reference ranges.
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Affiliation(s)
- Miriam Wanner
- Cancer Registry Zurich and Zug, Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Katarina L. Matthes
- Cancer Registry Zurich and Zug, Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dimitri Korol
- Cancer Registry Zurich and Zug, Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Silvia Dehler
- Cancer Registry Zurich and Zug, Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Sabine Rohrmann
- Cancer Registry Zurich and Zug, Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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