Trends in in-patient hospital utilization and surgical procedures for breast, prostate, lung and colorectal cancers in Canada.
OBJECTIVE
To analyse population-based trends of in-patient surgical procedures for breast (female), prostate, lung and colorectal cancers.


METHODS
The Hospital Morbidity Files supplied hospital data and the Canadian Cancer Registry, incidence data. Age-adjusted rates were standardized to the 1991 Canadian population.


RESULTS
All four cancers showed major changes in trends of surgical procedures. For breast cancer, the rate of in-patient breast conservation surgery (BCS) increased from 1981 to the early 1990s while the rate of mastectomy decreased. Because day surgery was not included, the subsequent in-patient BCS rate stayed level. For prostate cancer, the rate of transurethral prostatectomy was initially high but decreased after 1990, while the rate of radical prostatectomy increased rapidly, only minimally affected by the PSA-related peak in incidence. The lung cancer lobectomy rate in men remained at 10/100,000 after 1986, but in women rose from 3/100,000 to 7/100,000, reflecting increasing lung cancer incidence. For colorectal cancer, right hemicolectomies and anterior resections increased, especially in men.


CONCLUSIONS
Surgery trends reflected changes in incidence and treatment preferences. Canadian trends were generally similar to US trends, although the timing of some of the changes differed. Canadians tended to use less invasive procedures such as BCS and anterior resection.
Neutel
C Ineke
CI
Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, 120 Colonnade Avenue, K1A 0K9, Ottawa, Canada. ineke_neutel@phac-aspc.gc.ca
Gao
Ru-Nie
RN
Wai
Elaine
E
Gaudette
Leslie A
LA
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000601:surgery*; D002170:Canada / Q000453:epidemiology; D003082:Colectomy / Q000379:methods / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008408:Mastectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D011013:Pneumonectomy / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D012042:Registries; D017678:Sex Distribution; D013521:Urologic Surgical Procedures, Male / Q000706:statistics & numerical data; D014600:Utilization Review