title: Convergence with SEER database achieved by a breast cancer network: a longitudinal benchmark of 5-year relative survival.
abstract: OBJECTIVE
  To benchmark outcomes of a German breast cancer network with the Surveillance Epidemiology and End Results programme (SEER) of the USA from a longitudinal point of view.
  
  
  METHODS
  All women receiving primary breast cancer therapy of three hospitals in a rural district of Marburg-Biedenkopf (Germany) of time intervals 1996-1997 and 2003-2004 were used to define local benchmark objects. Data from SEER-programme contributed longitudinal benchmark objects from national level (1988-2004). All benchmark objects were compared with the time-fixed benchmark reference of SEER (2004). Stage distributions and 5-year relative survival ratios were combined to estimate standardized screening-, case-mix-, work-up-, treatment- and relative overall performance index.
  
  
  RESULTS
  From the entry cohort of 877 German women, 97.7 % of the patients accounted for the institutional sample (N = 857) and 65.8 % accounted for the regional sample (N = 577). Stage distributions, relative survival ratios and indices of the German breast cancer network improved over time. Developed indices converged with SEER (2004).
  
  
  CONCLUSIONS
  Effectiveness gap between one exemplary German breast cancer network and international benchmark defined by SEER has been closed. Reasons are manifold, and further research is recommended.
authors.affiliation: Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Square J5, 68159, Mannheim, Germany, christian.jacke@zi-mannheim.de.
authors.forename: Christian O
authors.initials: CO
authors.lastname: Jacke
authors.forename: Ute S
authors.initials: US
authors.lastname: Albert
authors.forename: Iris
authors.initials: I
authors.lastname: Reinhard
authors.forename: Matthias
authors.initials: M
authors.lastname: Kalder
mesh_terms: D000328:Adult; D000368:Aged; D019985:Benchmarking; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D015986:Confounding Factors, Epidemiologic; D016208:Databases, Factual; D005260:Female; D005858:Germany / Q000453:epidemiology; D018166:Health Care Reform; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D018426:SEER Program; D015983:Selection Bias; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology