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Rojas-Díaz D, Puerta-Yepes ME, Medina-Gaspar D, Botero JA, Rodríguez A, Rojas N. Mathematical Modeling for the Assessment of Public Policies in the Cancer Health-Care System Implemented for the Colombian Case. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6740. [PMID: 37754600 PMCID: PMC10531264 DOI: 10.3390/ijerph20186740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/28/2023] [Accepted: 07/20/2023] [Indexed: 09/28/2023]
Abstract
The incidence of cancer has been constantly growing worldwide, placing pressure on health systems and increasing the costs associated with the treatment of cancer. In particular, low- and middle-income countries are expected to face serious challenges related to caring for the majority of the world's new cancer cases in the next 10 years. In this study, we propose a mathematical model that allows for the simulation of different strategies focused on public policies by combining spending and epidemiological indicators. In this way, strategies aimed at efficient spending management with better epidemiological indicators can be determined. For validation and calibration of the model, we use data from Colombia-which, according to the World Bank, is an upper-middle-income country. The results of the simulations using the proposed model, calibrated and validated for Colombia, indicate that the most effective strategy for reducing mortality and financial burden consists of a combination of early detection and greater efficiency of treatment in the early stages of cancer. This approach is found to present a 38% reduction in mortality rate and a 20% reduction in costs (% GDP) when compared to the baseline scenario. Hence, Colombia should prioritize comprehensive care models that focus on patient-centered care, prevention, and early detection.
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Affiliation(s)
- Daniel Rojas-Díaz
- Area of Fundamental Sciences, School of Applied Sciences and Engineering, Universidad EAFIT, Medellin 050022, Colombia
| | - María Eugenia Puerta-Yepes
- Area of Fundamental Sciences, School of Applied Sciences and Engineering, Universidad EAFIT, Medellin 050022, Colombia
| | - Daniel Medina-Gaspar
- School of Finance, Economics, and Government, Universidad EAFIT, Medellin 050022, Colombia
| | - Jesús Alonso Botero
- School of Finance, Economics, and Government, Universidad EAFIT, Medellin 050022, Colombia
| | - Anwar Rodríguez
- Center for Economic Studies, National Association of Financial Institutions (ANIF), Bogota 110231, Colombia
| | - Norberto Rojas
- Center for Economic Studies, National Association of Financial Institutions (ANIF), Bogota 110231, Colombia
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Jamili S, Yousefi M, Pour HE, Houshmand E, Taghipour A, Tabatabaee SS, Adel A. Comparison of pay-for-performance (P4P) programs in primary care of selected countries: a comparative study. BMC Health Serv Res 2023; 23:865. [PMID: 37580717 PMCID: PMC10426118 DOI: 10.1186/s12913-023-09841-6] [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: 04/26/2023] [Accepted: 07/22/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Pay for performance (P4P) schemes provide financial incentives or facilities to health workers based on the achievement of predetermined performance goals. Various P4P programs have been implemented around the world. There is a question of which model is suitable for p4p implementation to achieve better results. The purpose of this study is to compare pay for performance models in different countries. METHODS This is a descriptive-comparative study comparing the P4P model in selected countries in 2022. Data for each country are collected from reliable databases and are tabulated to compare their payment models. the standard framework of the P4P model is used for data analysis. RESULTS we used the standard P4P model framework to compare pay for performance programs in the primary care sector of selected countries because this framework can demonstrate all the necessary features of payment programs, including performance domains and measures, basis for reward or penalty, nature of the reward or penalty, and data reporting. The results of this study show that although the principles of P4P are almost similar in the selected countries, the biggest difference is in the definition of performance domains and measures. CONCLUSIONS Designing an effective P4P program is very complex, and its success depends on a variety of factors, from the socioeconomic and cultural context and the healthcare goals of governments to the personal characteristics of the healthcare provider. considering these factors and the general framework of the features of P4P programs are critical to the success of the p4p design and implementation.
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Affiliation(s)
- Sara Jamili
- Student Research Committee, Department of Health Economics and Management Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Yousefi
- Department of Health Economics and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hossein Ebrahimi Pour
- Department of Health Economics and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Houshmand
- Department of Health Economics and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Saeed Tabatabaee
- Department of Health Economics and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Adel
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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Strohbehn GW, Cooperrider JH, Yang D, Fendrick AM, Ratain MJ, Zaric GS. Pfizer and Palbociclib in China: Analyzing an Oncology Pay-for-Performance Plan. Value Health Reg Issues 2022; 31:34-38. [DOI: 10.1016/j.vhri.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/21/2021] [Accepted: 01/23/2022] [Indexed: 10/18/2022]
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Mousaloo A, Amir-Behghadami M, Janati A, Gholizadeh M. Exploring the challenges and features of implementing performance-based payment plan in hospitals: a protocol for a systematic review. Syst Rev 2021; 10:114. [PMID: 33863372 PMCID: PMC8052724 DOI: 10.1186/s13643-021-01657-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implementing performance-based payment (PBP) plan has led to developing a number of significant potentialities such as performance improvement and effectiveness, quality improvement of provided services, and decline in health system expenditure in hospitals. Despite the fact that PBP plan has a variety of potential advantages, its implementation still may face some challenges. Hence, it seems crucial to identify these barriers and challenges in order to devise some strategies and interventions to pave the way for better implementation of PBP in hospitals. The aim of this proposed protocol is to identify, summarize, and synthesize the existing evidence by undertaking a systematic review to explore the challenges, barriers, and features of implementing PBP in hospitals. METHODS AND ANALYSIS An inclusive search of the literature will be conducted in seven international and national databases including PubMed/MEDLINE, Scopus, Cochrane Library and Web of Science, Magiran, Scientific Information Database (SID), and Barakat knowledge network system (BKNS). The search will be limited to the studies published in English or Persian language. Database search will be supplemented by hand-search of citation, reference lists, and grey literature sources. Based on the pre-established criteria in all steps of the review, two researchers will independently screen all of the retrieved studies. Any discrepancies will be resolved through a discussion between two researchers. In cases where consensus is not reached, it will be referred to a third researcher. The methodological quality of all the included studies will be appraised using the Mixed Methods Appraisal Tool (MMAT). The data will be extracted by means of using a data extraction form, which will be developed and piloted by the research team. The findings will be synthesized through directed content analysis method. DISCUSSION With the growth and development of payment systems all over the world, it is expected that recognizing the challenges of implementing a PBP plan in hospitals will be useful in developing and designing strategies to better implement this plan. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020152569.
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Affiliation(s)
- Asieh Mousaloo
- Student Research Committee (SRC), Tabriz University of Medical Sciences, Tabriz, Iran.,Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran
| | - Mehrdad Amir-Behghadami
- Student Research Committee (SRC), Tabriz University of Medical Sciences, Tabriz, Iran. .,Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran. .,Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ali Janati
- Student Research Committee (SRC), Tabriz University of Medical Sciences, Tabriz, Iran.,Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran.,Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Gholizadeh
- Student Research Committee (SRC), Tabriz University of Medical Sciences, Tabriz, Iran.,Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran.,Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Aghajani MH, Manavi S, Maher A, Rafiei S, Ayoubian A, Shahrami A, Ronasiyan R, Maziar P. Pay for performance in hospital management: A case study. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2021. [DOI: 10.1080/20479700.2019.1664029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Saeed Manavi
- Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Maher
- Department of Health Policy, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ali Ayoubian
- Department of Health Services Management, College of Management and Social Science, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Shahrami
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Pooneh Maziar
- Ministry of Health and Medical Education, Tehran, Iran
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Zaresani A, Scott A. Is the evidence on the effectiveness of pay for performance schemes in healthcare changing? Evidence from a meta-regression analysis. BMC Health Serv Res 2021; 21:175. [PMID: 33627112 PMCID: PMC7905606 DOI: 10.1186/s12913-021-06118-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/25/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This study investigated if the evidence on the success of the Pay for Performance (P4P) schemes in healthcare is changing as the schemes continue to evolve by updating a previous systematic review. METHODS A meta-regression analysis using 116 studies evaluating P4P schemes published between January 2010 to February 2018. The effects of the research design, incentive schemes, use of incentives, and the size of the payment to revenue ratio on the proportion of statically significant effects in each study were examined. RESULTS There was evidence of an increase in the range of countries adopting P4P schemes and weak evidence that the proportion of studies with statistically significant effects have increased. Factors hypothesized to influence the success of schemes have not changed. Studies evaluating P4P schemes which made payments for improvement over time, were associated with a lower proportion of statistically significant effects. There was weak evidence of a positive association between the incentives' size and the proportion of statistically significant effects. CONCLUSION The evidence on the effectiveness of P4P schemes is evolving slowly, with little evidence that lessons are being learned concerning the design and evaluation of P4P schemes.
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Affiliation(s)
- Arezou Zaresani
- University of Manitoba, Institute for Labor Studies (IZA) and Tax and Transfer Policy Institute (TTPI), 15 Chancellors Circle, Fletcher Argue Building, Winnipeg, Manitoba, Canada.
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Mauro M, Rotundo G, Giancotti M. Effect of financial incentives on breast, cervical and colorectal cancer screening delivery rates: Results from a systematic literature review. Health Policy 2019; 123:1210-1220. [PMID: 31587819 DOI: 10.1016/j.healthpol.2019.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 09/18/2019] [Accepted: 09/20/2019] [Indexed: 01/23/2023]
Abstract
Preventive care, such as screening, is important for reducing the risk of cancer, a leading cause of death worldwide. Indeed, some type of cancers are detected through screening programs, which in most countries run for colorectal, breast, and cervical cancers. In this context, general practitioners play a key role in increasing the participation rate in cancer screening programs. To improve cancer screening delivery rates, performance incentives have increasingly been implemented in primary care by healthcare payers and organizations in different countries. The effects of these tools are still not clear. We conducted a systematic literature review in order to answer the following research question: What is the evidence in the literature for the effects of financial incentives on the delivery rates of breast, cervical and colorectal cancer screening in general practice? We performed a literature search in Web of Science, PubMed, Cochrane Library and Google Scholar, according to the PRISMA guidelines. 18 studies were selected, classified and discussed according to the health preventive services investigated. Most of studies showed partial or no effects of financial incentives on breast and cervical cancer screening delivery rates. Few positive or partial effects were found regarding colorectal cancer screening. Ongoing monitoring of incentive programs is critical to determining the effectiveness of financial incentives and their effects on the improvement of cancer screening delivery rates.
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Affiliation(s)
- Marianna Mauro
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy.
| | - Giorgia Rotundo
- Department of Legal, Historical, Economic and Social Sciences, Magna Graecia University, Catanzaro, Italy.
| | - Monica Giancotti
- Department of Clinical and Experimental Medicine, Magna Graecia University, Viale Europa, Catanzaro, Italy.
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Abstract
This article reviews the literature on the use of financial incentives to improve the provision of value-based health care. Eighty studies of 44 schemes from 10 countries were reviewed. The proportion of positive and statistically significant outcomes was close to .5. Stronger study designs were associated with a lower proportion of positive effects. There were no differences between studies conducted in the United States compared with other countries; between schemes that targeted hospitals or primary care; or between schemes combining pay for performance with rewards for reducing costs, relative to pay for performance schemes alone. Paying for performance improvement is less likely to be effective. Allowing payments to be used for specific purposes, such as quality improvement, had a higher likelihood of a positive effect, compared with using funding for physician income. Finally, the size of incentive payments relative to revenue was not associated with the proportion of positive outcomes.
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Affiliation(s)
- Anthony Scott
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Miao Liu
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Jongsay Yong
- The University of Melbourne, Melbourne, Victoria, Australia
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McPherson E, Hedden L, Regier DA. Impact of oncologist payment method on health care outcomes, costs, quality: a rapid review. Syst Rev 2016; 5:160. [PMID: 27653974 PMCID: PMC5031322 DOI: 10.1186/s13643-016-0341-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 09/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of cancer and the cost of its treatment continue to rise. The effect of these dual forces is a major burden on the system of health care financing. One cost containment approach involves changing the way physicians are paid. Payers are testing reimbursement methods such as capitation and prospective payment while also evaluating how the changes impact health outcomes, resource utilization, and quality of care. The purpose of this study is to identify evidence related to physician payment methods' impacts, with a focus on cancer control. METHODS We conducted a rapid review. This involved defining eligibility criteria, identifying a search strategy, performing study selection according to the eligibility criteria, and abstracting data from included studies. This process was accompanied by a gray literature search for special topics. RESULTS The incentives in fee-for-service payment systems generally lead to health care services being applied inconsistently because providers practice independently with few systems in place for developing treatment protocols and practice reviews. This inconsistency is pronounced in cancer care because much of the total per patient spending occurs in the last month of life. Some insurers are predicting that this variation can be reduced through the use of prospective or bundled payments combined with decision support systems. Workload, recruitment, and retention are all affected by changes to physician payment models; effects seem to be magnified in the specialist context as their several extra years of training lower their overall supply. CONCLUSIONS Experimentation with physician payment methods has tended to neglect cancer care providers. Policymakers designing cancer-focused physician reimbursement pilot programs should incorporate quality measurement since very ill patients may receive too little treatment when payment models do not cover oncologists' total costs, e.g., fee-for-service systems whose prices do not account for the possible presence of other diseases.
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Affiliation(s)
- Emily McPherson
- Canadian Centre for Applied Research in Cancer Control (ARCC), School of Population and Public Health, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, V5Z 1G1, Canada.
| | - Lindsay Hedden
- Centre for Clinical Epidemiology and Evaluation, University of British Columbia, 828 West 10th Avenue, Vancouver, British Columbia, V5Z 1M9, Canada
| | - Dean A Regier
- Canadian Centre for Applied Research in Cancer Control (ARCC), School of Population and Public Health, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, V5Z 1G1, Canada
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Li T, Mello-Thoms C, Brennan PC. Descriptive epidemiology of breast cancer in China: incidence, mortality, survival and prevalence. Breast Cancer Res Treat 2016; 159:395-406. [PMID: 27562585 DOI: 10.1007/s10549-016-3947-0] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/13/2016] [Indexed: 01/24/2023]
Abstract
Breast cancer is the most common neoplasm diagnosed amongst women worldwide and is the leading cause of female cancer death. However, breast cancer in China is not comprehensively understood compared with Westernised countries, although the 5-year prevalence statistics indicate that approximately 11 % of worldwide breast cancer occurs in China and that the incidence has increased rapidly in recent decades. This paper reviews the descriptive epidemiology of Chinese breast cancer in terms of incidence, mortality, survival and prevalence, and explores relevant factors such as age of manifestation and geographic locations. The statistics are compared with data from the Westernised world with particular emphasis on the United States and Australia. Potential causal agents responsible for differences in breast cancer epidemiology between Chinese and other populations are also explored. The need to minimise variability and discrepancies in methods of data acquisition, analysis and presentation is highlighted.
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Affiliation(s)
- Tong Li
- Medical Image Optimisation and Perception Group (MIOPeG), Department of Medical Imaging & Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East Street, Lidcombe, NSW, 2141, Australia.
| | - Claudia Mello-Thoms
- Medical Image Optimisation and Perception Group (MIOPeG), Department of Medical Imaging & Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East Street, Lidcombe, NSW, 2141, Australia
| | - Patrick C Brennan
- Medical Image Optimisation and Perception Group (MIOPeG), Department of Medical Imaging & Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East Street, Lidcombe, NSW, 2141, Australia
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Zhu J, Chen JG, Chen YS, Zhang YH, Ding LL, Chen TY. Female breast cancer survival in Qidong, China, 1972-2011: a population-based study. BMC Cancer 2014; 14:318. [PMID: 24886526 PMCID: PMC4016778 DOI: 10.1186/1471-2407-14-318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 04/28/2014] [Indexed: 08/30/2023] Open
Abstract
Background Based on data from the population-based Qidong Cancer Registry, we report a survival analysis for female breast cancer patients diagnosed during 1972–2011 in order to assess the long-term trends for the prognosis of this cancer. Methods The last follow-up for survival status of the 3,398 registered female breast cancer cases was April, 2012. Cumulative observed survival (OS) and relative survival (RS) rates were calculated using Hakulinen’s method performed by the SURV3.01 Software developed at the Finnish Cancer Registry. Results The one-, three-, five-, ten-, fifteen-, twenty-, thirty-, and forty- year OS rates were 83.61%, 67.53%, 58.75%, 48.56%, 42.57%, 38.30%, 29.19%, 19.35%; and the RS rates were 84.76%, 70.45%, 63.12%, 56.81%, 55.26%, 56.36%, 62.59%, 84.00%, respectively. Five-year RS rates of age groups 15–34, 35–44, 45–54, 55–64, 65–74, and 75+ were 60.17%, 68.27%, 67.79%, 56.03%, 55.50%, and 57.28%; 10-year RS rates were 54.16%, 59.59%, 61.34%, 47.78%, 51.30%, and 59.28%, respectively. There were statistical differences among the age groups (RS: χ2 = 152.15, P = 0.000). Remarkable improvement could be seen for the 5-year RS rates from 52.08% in 1972 to 69.26% in 2003–2007, and the 10-year RS rates from 43.16% in 1972 to 60.85% in 1998–2002, respectively. Conclusions Survival outcomes from Qidong registered cases with breast cancer have shown gradual progress during the past 40 years. The disparities between survival rates of this area and developed countries are getting narrower, but there is still great need for improving survival in Qidong.
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Affiliation(s)
| | - Jian-Guo Chen
- Qidong Liver Cancer Institute, Qidong Cancer Registry, Qidong People's Hospital, Qidong 226200, China.
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