title: Are there regional differences in the management of colon cancer in France?
abstract: The purpose of this study was to assess possible regional disparities in the management of colon cancer in France. In 1995, 1605 patients with a colon cancer in eight areas covered by a population-based cancer registry were studied. Pre-therapeutic work-up, stage at diagnosis and therapeutic modalities were assessed. There were no differences between areas concerning the resection or the stage at diagnosis. The proportion of patients with a colonoscopy alone varied between 42.7 and 70.4% (P<0.001). The use of both colonoscopy and barium enema was even more heterogeneous (extremes from 11.7 to 40.2%, P<0.001). There were significant differences in the performance of abdominal computed tomography and tumour markers. The number of examined lymph nodes was lower than the recommendation in 47.3% of cases with extremes ranging from 36.9 to 60.9%. Adjuvant chemotherapy was performed on average in 49.4% of cases in stage II (in which it is not recommended) with extremes from 18.8 to 72.5% (P<0.001) and in 79.6% of the cases in stage III (in which it is recommended) with extremes from 63.6 to 94.4% (P=0.08). In conclusion, these results should alert practitioners and health care authorities in order to homogenize practices.
authors.affiliation: Côte-d'Or and Saône-et-Loire Cancer Registry, CRI INSERM 95 05 et DRED 1789 Faculté de médecine, 7 Boulevard Jeanne d'Arc, 21000 Dijon, France. JMPhelip@chu-grenoble.fr
authors.forename: J M
authors.initials: JM
authors.lastname: Phelip
authors.forename: P
authors.initials: P
authors.lastname: Grosclaude
authors.forename: G
authors.initials: G
authors.lastname: Launoy
authors.forename: M
authors.initials: M
authors.lastname: Colonna
authors.forename: A
authors.initials: A
authors.lastname: Danzon
authors.forename: M
authors.initials: M
authors.lastname: Velten
authors.forename: B
authors.initials: B
authors.lastname: Tretarre
authors.forename: A M
authors.initials: AM
authors.lastname: Bouvier
authors.forename: J
authors.initials: J
authors.lastname: Faivre
mesh_terms: D000368:Aged; D001464:Barium; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D003113:Colonoscopy / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D004733:Enema; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D001464:Barium