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Lemmon, Elizabeth and Hanna, Catherine and Diernberger, Katharina and Paterson, Hugh M. and Wild, Sarah H. and Ennis, Holly and Hall, Peter S. (2024) Variation in colorectal cancer treatment and outcomes in Scotland: Real world evidence from national linked administrative health data. International Journal of Population Data Science, 9 (1): 2179. ISSN 2399-4908

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This study analyzed a Scottish population of patients with early-stage colon and rectal cancer treated with surgery. The results showed significant variation in mortality by sex, area-based deprivation, and geographic location.

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Abstract

Background:
Colorectal cancer (CRC) is the fourth most common type of cancer in the United Kingdom and the second leading cause of cancer death. Despite improvements in CRC survival over time, Scotland lags behind its UK and European counterparts. In this study, we carry out an exploratory analysis which aims to provide contemporary, population level evidence on CRC treatment and survival in Scotland.

Methods:
We conducted a retrospective population-based analysis of adults with incident CRC registered on the Scottish Cancer Registry (Scottish Morbidity Record 06 (SMR06)) between January 2006 and December 2018. The CRC cohort was linked to hospital inpatient (SMR01) and National Records of Scotland (NRS) deaths records allowing a description of their demographic, diagnostic and treatment characteristics. Cox proportional hazards regression models were used to explore the demographic and clinical factors associated with all-cause mortality and CRC specific mortality after adjusting for patient and tumour characteristics among people identified as early-stage and treated with surgery.

Results:
Overall, 32,691 (73%) and 12,184 (27%) patients had a diagnosis of colon and rectal cancer respectively, of whom 55% and 53% were early-stage and treated with surgery. Five year overall survival (CRC specific survival) within this cohort was 72% (82%) and 76% (84%) for patients with colon and rectal cancer respectively. Cox proportional hazards models revealed significant variation in mortality by sex, area-based deprivation and geographic location.

Conclusions:
In a Scottish population of patients with early-stage CRC treated with surgery, there was significant variation in risk of death, even after accounting for clinical factors and patient characteristics.

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Lemmon, Elizabeth

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Hanna, Catherine

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Ward, Laura McKernan and Cooper, Sally-Ann and Sosenko, Filip and Morrison, David and Fleming, Michael and McCowan, Colin and Robb, Katie and Hanna, Catherine R. and Hughes-McCormack, Laura and Dunn, Kirsty and Conway, David and Henderson, Angela and Smith, Gill and Truesdale, Maria and Cairns, Deborah (2024) Population-based cancer incidence and mortality rates and ratios among adults with intellectual disabilities in Scotland: a retrospective cohort study with record linkage. BMJ Open, 14 (8): e084421. ISSN 2044-6055