Differences found in rectal cancer treatment between European countries

2011 European Multidisciplinary Cancer Congress

There are substantial differences in the use of chemotherapy and radiotherapy for rectal cancer between European countries.

The European Registration of Cancer Care (EURECCA) study compared the treatment of 6,597 patients in Sweden, Norway, Denmark and the Netherlands who were diagnosed with rectal cancer from 2008 to 2009. The study was initiated by the European Cancer Organization (ECCO). According to study researcher Colette van den Broek, MD, a PhD student and research fellow at Leiden University Medical Center in the Netherlands, the researchers aimed to identify factors that played a role in improving clinical practice.

"It is clear from our results so far that different countries in Europe have different guidelines for treating rectal cancer patients," van den Broek said in a press release. "With this study, we hope to be able to give an answer to the ongoing discussion about this, and it is a first step toward a single guideline that can be used in different countries."

The use of radiotherapy, chemotherapy or both was lowest in Denmark at 25%, whereas the highest was in the Netherlands at 81%. Its use varied depending on the stage of the disease. In Denmark and the Netherlands, patients with stage I, stage II or stage III disease received radiotherapy, chemotherapy or both most often. In Sweden, patients with stage II or stage III disease received it more often, and in Norway, patients with stage IV disease received it more often.

The researchers are now comparing the deaths within 30 days of surgery between the countries. The EURECCA project will also look at similar comparisons for other cancers, and the researchers will also look at long-term survival as well.

"This is just a first step in the process," van den Broek said.

For more information:

Van den Broek C. #6000. Presented at: 2011 European Multidisciplinary Cancer Congress; Sept. 23-27; Stockholm, Sweden.

Cancer professionals know well that treatment practice varies widely in Europe. These differences have many reasons, such as regional experience and expertise, as well as available infrastructure. To some extent, differences in approach may, therefore, be quite appropriate. On the other hand, it appears unlikely that all different approaches could be equally effective and equally well-tolerable. Comparison of outcomes after different approaches in large cohorts is an evidence-based way to identify shortcomings in specific services. For this reason, ECCO and several of its member societies strongly support the EURECCA study, which provides a showcase on what can be achieved for improved cancer care by such multidisciplinary, multinational clinical research projects.

– Michael Baumann, MD
President of European Cancer Organization

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