Introduction
Identifying unwarranted variations in cancer care between states highlights opportunities for improving patient care and provides real-world comparisons of cancer specific indicators based on clinical guidelines. This study aimed to compare state-wide cancer treatment and survival data among patients with breast or gynaecological cancers between Queensland (Qld) and Victoria (Vic).
Methods
Queensland data were obtained from the Qld Oncology Repository and Victorian data from the Centre for Victorian Data Linkage Integrated Data Resource. Both resources involved linkage with multiple state-wide datasets. Breast and gynaecological cancer patients diagnosed between 2015-2019 were included (breast cancer: Vic n = 22,433, Qld n = 17,586; gynaecological cancer: Vic n = 6,707, Qld n = 5,449). The datasets were not combined, and the methodology and indicators were based on Qld Cancer Quality Index.
Results
For breast cancer the outcomes were similar for surgical rates (Vic: 89%, Qld: 90%), radiation therapy rates (Vic 67%, Qld 69%), 90-day surgical mortality (0.2% in both states) and 2-year surgical survival (97% in both states). Similar surgical and radiation therapy rates were observed for cervical, ovarian, uterine and vulva cancer patients. Mortality within 90 days of surgery was higher among gynaecological cancer patients in Vic (1.3%) than those in Qld (0.7%), with two-year surgical survival similar (Vic 89%; Qld 90%).
Further analysis is required; however, this initial comparison instils confidence to extend analyses to include other cancers and to investigate priority populations such as those living in rural and remote areas, elderly, lower socioeconomic status and First Nations peoples.
Conclusions
This project demonstrates the mutual benefit of identifying areas of improvement in Vic and Qld. It serves as a model for other Australian states to join and enable the development of reporting to drive tracking of healthcare performance towards best practice and improved outcomes for people with cancer.