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Breast cancer in the West Midlands: an evaluation of screening, treatment and survival

Teale, Alison Mary Jennifer (1997)
Ph.D. thesis, University of Birmingham.

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Abstract

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.

Type of Work:Ph.D. thesis.
Supervisor(s):Lawrence, Gill and Winter, Heather and Griffiths, R. K. (Rod K.)
School/Faculty:Faculties (to 1997) > Faculty of Medicine and Dentistry
Department:Public Health and Epidemiology
Additional Information:

Scanned from the typescript. The optical character recognition process has rendered some characters in inconsistent fonts or styles.

Subjects:R Medicine (General)
RA0421 Public health. Hygiene. Preventive Medicine
Institution:University of Birmingham
Library Catalogue:Check for printed version of this thesis
ID Code:207
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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