Research roundup: July 2017
An overview of recent studies relating to cancer prevention and care.
Tackling wastage in breast cancer care with real-world data analysis
A study conducted in Italy used real-world data (key performance indicators) to identify potential wastage and inappropriateness in breast cancer care. The data were collected from a cancer registry, a clinical database and two administrative databases. The findings showed that linking multiple healthcare databases to gather real-world data is feasible. The study identified a total of 2,516 inappropriate examinations in a five-year timeframe, accounting for potentially avoidable costs of €573,510.80.
Cancer death rates show slower decrease than CVD death rates
A study published in the BMJ compares the evolution of cancer and cardiovascular disease (CVD) life expectancy and mortality rates from 1981 to 2010 globally. In high-income countries, declines in lung cancer mortality rates led to the largest gain in life expectancy for men. For women, declines in breast cancer mortality rates brought about the largest gain in life expectancy. While both CVD and cancer mortality rates decreased, cancer mortality rates fell at a slower pace. The authors attribute this to inequities in implementation of cancer control.
Web-based interventions make a case for mHealth at ASCO 2017
Two studies presented at the American Society of Clinical Oncology (ASCO) Annual Meeting reported on results of web-based interventions in cancer care. The studies exemplified the potential of such interventions, in terms of both patient outcomes and potential cost savings.
A randomised controlled trial showed significant benefits of a web-based platform enabling patients with a range of metastatic cancers (mostly gynaecological and lung) to report their experience of symptoms and side effects to healthcare professionals between regular appointments. In the intervention group, quality of life improved and survival increased by five months. The authors noted that the intervention was highly cost-effective: it was inexpensive to develop and did not take up additional time for healthcare professionals. It may also reduce the number of hospital admissions.
The second mHealth intervention presented at ASCO was a remote therapy programme used with primarily breast cancer patients in Austria, Germany and Switzerland. It aimed to help newly diagnosed cancer patients cope with their diagnosis. Findings showed improvements in participants’ quality of life.
Using the ASCO and ESMO frameworks to assess cost and benefit in cancer care
A review of randomised controlled trials in non-small-cell lung cancer, breast cancer, colorectal cancer, and pancreatic cancer found only a fair correlation between two major value frameworks: the American Society of Clinical Oncology (ASCO) and European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale (MCBS). In the ASCO framework, there is a negative association between the benefit score and drug costs. A comment in Lancet Oncology finds the ‘degree of discordance troubling’, noting that neither framework includes the duration of benefit or the burden of illness on patients (e.g. their ability to remain in work). The authors also conclude that more developmental work is needed to ensure that the ASCO and ESMO frameworks provide meaningful and credible assessments of value before they are used in the real world.
Read the comment: Measuring value and benefit—a matter of perspective