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Title: Breast cancer in the West Midlands : an evaluation of screening, treatment and survival
Author: Teale, Alison Mary Jennifer
ISNI:       0000 0001 3515 557X
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 1997
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High quality population based data are essential to evaluate breast cancer. This study has improved data quality at the West Midlands Cancer Intelligence Unit through the development of a staging algorithm which significantly increased the proportion of cases with stage recorded. It has also demonstrated the benefits of combining cancer registry data with those from the NHS Breast Screening Programme (NHSBSP). This study identified stage as the most significant prognostic factor for breast cancer patients, and the favourable staging characteristics of screen detected cancers thus suggest that improved survival should result. The study also found that only 31.6% of cancers in eligible women were screen detected in the prevalent round. As 31% of breast cancers arose in women in the screening age range, only an estimated 10% of breast cancer patients benefit directly from screening. High interval cancer rates were identified, along with the need for clarification of the definitions used to identify interval cancers. This investigation identified changes in treatment over time across the region towards the King's Fund guidelines. However, treatment varied across the region and clear divergences from the guidelines were apparent. Furthermore, no association was identified between surgical caseload and survival, suggesting that the use of caseload as a proxy for specialist care may be questionable.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: R Medicine (General) ; RA0421 Public health. Hygiene. Preventive Medicine