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A population perspective on the use of external beam radiotherapy in Catalonia, Spain

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Abstract

Purpose

To assess the use of external beam radiotherapy in Catalonia (Spain), overall and by health management area.

Methods

We assessed radiotherapy treatments in a cohort of patients diagnosed with cancer from 2009 to 2011, using the population-based cancer registries in Girona and Tarragona. Participants had to have a minimum follow-up of 5 years from the time the cancer registry database was linked to the catalan health service database for financing radiation oncology. Outcomes included the proportion of patients receiving radiotherapy within 1 and 5 years of diagnosis. A log-binomial model was used to assess age-related trends in the use of radiotherapy by tumour site. Finally, we calculated the standardized utilization rate and 95% confidence intervals by health management area covered by the radiation oncology services, using indirect methods.

Results

At 1 and 5 years from diagnosis, 21.4 and 24.4% of patients, respectively, had received external beam radiotherapy. Patients aged 40–64 years had the most indications for the treatment, and there was a negative correlation between the patients’ age and the use of radiotherapy for most tumour sites (exceptions were cervical, thyroid, and uterine cancers). There were no statistically significant differences in the use of radiotherapy according to th health management area.

Conclusions

Population-based data show that external beam radiotherapy is underutilized in Catalonia. This situation requires a careful analysis to understand the causes, as well as an improvement of the available resources, oriented toward achieving realistic targets for the optimal use of external beam radiotherapy in our country.

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Acknowledgements

We thank Araceli Jiménez for her participation in the collection and validation of the data from the Tarragona Cancer Registry, Sonia Mosteiro for her contributions to the analysis, and Meggan Harris for her support in editing the manuscript.

Funding

This work was partially supported by the Fund for Health Research (FIS, PI15/00945) of the Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII) (co-funded by FEDER funds/European Regional Development Funds, ERDF), and the Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR, 2017SGR00935).

Author information

Authors and Affiliations

  1. Cancer Plan, Department of Health, Generalitat de Catalunya, Barcelona, Spain

    J. Corral, J. Solà, J. A. Espinàs & J. M. Borras

  2. Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain

    J. Corral, J. Solà, J. A. Espinàs & J. M. Borras

  3. Tarragona Cancer Registry, Foundation League for Research Into the Prevention of Cancer (FUNCA), Reus, Spain

    J. Galceran, M. Carulla & L. Llauradó

  4. Pere Virgili Health Research Institute (IISPV), Reus, Spain

    J. Galceran & M. Carulla

  5. Epidemiology Unit and Girona Cancer Registry, Cancer Plan, Department of Health, Generalitat de Catalunya, Catalan Institute of Oncology, Girona, Spain

    R. Marcos-Gragera, Á. Izquierdo & L. Vilardell

  6. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain

    R. Marcos-Gragera, Á. Izquierdo & L. Vilardell

  7. University of Girona (UdG), Girona, Spain

    R. Marcos-Gragera

  8. Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    R. Marcos-Gragera

  9. Medical Oncology Department, Hospital Josep Trueta, Catalan Institute of Oncology of Girona, Girona, Spain

    Á. Izquierdo

  10. Department of Clinical Sciences, University of Barcelona, Barcelona, Spain

    J. M. Borras

Authors
  1. J. Corral
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  2. J. Solà
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  3. J. Galceran
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  4. R. Marcos-Gragera
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  5. M. Carulla
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  6. Á. Izquierdo
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  7. L. Vilardell
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  8. L. Llauradó
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  9. J. A. Espinàs
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  10. J. M. Borras
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Contributions

JC, JE and JMB contributed to the study conception and design. JG, RM, MC, AI, LV, LL contributed to data collection. JC, JS, JG, JE, JB were responsible for data analysis and data interpretation. JC and JB were responsible for manuscript writing. All authors were responsible for the approval of the manuscript.

Corresponding author

Correspondence to J. M. Borras.

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Conflict of interest

The authors declared no conflicts of interest.

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Data is not publicly available. Data can be requested through e-mail to corresponding author.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the Trust and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study formal consent is not required.

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Corral, J., Solà, J., Galceran, J. et al. A population perspective on the use of external beam radiotherapy in Catalonia, Spain. Clin Transl Oncol 22, 2222–2229 (2020). https://doi.org/10.1007/s12094-020-02355-1

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  • DOI: https://doi.org/10.1007/s12094-020-02355-1

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