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Access to specialized pediatric cancer care in Switzerland
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID
524378
Author(s)
Adam, Martin; von der Weid, Nicolas; Michel, Gisela; Zwahlen, Marcel; Lutz, Jean-Michel; Probst-Hensch, Nicole; Niggli, Felix; Kuehni, Claudia; Swiss Pediatric Oncology Group (SPOG); Swiss Association of Cancer Registries (ASRT)
Access to specialized pediatric cancer care in Switzerland
Journal
Pediatric blood & cancer
Volume
54
Number
5
Pages / Article-Number
721-7
Keywords
adolescents, cancer center, health care provider/services, quality of care
Abstract
BACKGROUND: Specialized pediatric cancer centers (PCCs) are thought to be essential to obtain state-of-the-art care for children and adolescents. We determined the proportion of childhood cancer patients not treated in a PCC, and described their characteristics and place of treatment. PROCEDURE: The Swiss Childhood Cancer Registry (SCCR) registers all children treated in Swiss PCCs. The regional cancer registries (covering 14/26 cantons) register all cancer patients of a region. The children of the SCCR with data from 7 regions (11 cantons) were compared, using specialized software for record linkage. All children <16 years of age at diagnosis with primary malignant tumors, diagnosed between 1990 and 2004, and living in one of these regions were included in the analysis. RESULTS: 22.1% (238/1,077) of patients recorded in regional registries were not registered in the SCCR. Of these, 15.7% (169/1,077) had never been in a PCC while 6.4% (69/1,077) had been in a PCC but were not registered in the SCCR, due to incomplete data flow. In all diagnostic groups and in all age groups, a certain proportion of children was treated outside a PCC, but this proportion was largest in children suffering from malignant bone tumors/soft tissue sarcomas and from malignant epithelial neoplasms, and in older children. The proportion of patients treated in a PCC increased over the study period (P < 0.0001). CONCLUSIONS: One in six childhood cancer patients in Switzerland was not treated in a PCC. Whether these patients have different treatment outcomes remained unclear