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Title: Will the creation of an adolescent cancer centre lead to improved outcomes in Yorkshire?
Author: Wilkinson, John Robert
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2001
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Objective: To assess the need for an adolescent cancer unit to serve the population in Yorkshire. Design: An epidemiological review of the data from two sources in the Northern and Yorkshire Region. A qualitative methodology was employed to assess the views of patients, healthy adolescents and staff on a unit away from the centre dealing with adolescents, on the benefits of a centralised adolescent unit. Interventions: None Results: Routine cancer registration data on 2411 adolescents registered with cancer between 1985 and 1994 were collected from the Northern and Yorkshire Cancer Registry and the Northern Children's Tumour Registry. The data related to 1375 patients in the former Yorkshire Region and 1036 patients in former Northern Region. Incidence data are presented for the two regions. Survival differed significantly between parts of Yorkshire but this did not appear to relate to place of treatment or social class. In the former Northern Region some differences were also apparent in survival, but the content of the data did not allow analysis by social class. However, in both instances survival appeared to be better in areas close to the cancer centre which was counter-intuitive to the expectations based on the known social class gradients in the former Yorkshire and Northern Regions. The qualitative studies discovered the specific needs of adolescents with cancer (e.g. the importance of peer group support and maintaining their education) and suggested that there could be benefit from centralised, specialised management. However, there were considerable potential flaws in the data which may render such a conclusion as debatable. Conclusions: This study adds weight to the proposal for the development of an adolescent cancer unit in Yorkshire, however, this study is by no means conclusive because of the absence of available data to answer this question. The reasons why, overall support should be given to create an adolescent unit fall into four categories: philosophical (the need to provide services which recognise the specific needs of adolescents) qualitative (the ability of specialist units to provide a higher quality of care) pragmatic ( the ability to concentrate specialist skills in one location) and improved outcome, this study suggests that outcome, and survival in particular differs may differ significantly according to where people live, and that this may be related to the type of care they receive. Further studies are needed to explain the apparent survival differences in the region.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available