End results, interhospital differences, and trends in patterns of care for gynecologic cancer

Survival rates represent one measure of population-wide progress in cancer control. Data from the Surveillance, Epidemiology and End Results (SEER program of the National Cancer Institute (NCI) document that, during the 1970s, survival rates for several cancers improved. For the major gynecologic cancers and breast cancer, improvements are evident for some sites but, areas of decline also are observed. Black women in the US have a poorer survival rate than white women and the trend in recent years suggest that this gap may be widening. Comparisons of survival rates from comprehensive cancer centers and population-based rates indicate differences in outcomes associated with the treatment setting. Data from the American College of Surgeons (ACS) patterns of care surveys suggest substantial interhospital variability in cancer survival which is largely explained by characteristics of the patient populations served. Recent studies of patterns of care document major shifts in treatment practices in the US and provide insight concerning the rate at which treatment changes are adopted at the community level.