[Surgical health care patterns and cancer cost: two studies using population registry data]

The goal of the first study was to analyze the surgical health care patterns for operated cases colorectal cancer. The role of surgery was analyzed for 732 cases diagnosed between 1988 and 1991 and recorded by the Doubs Cancer Registry, France. Young patients were more inclined to surgery than the older patients: 41% before 65 years and 27% after 65 (p < 0.02). Age was the only variable related to the type of activity of the surgeon (public or private sector): 65.9% of patients younger than 65 years were treated by a private surgeon but only 56.6% of patients older than 65 (p < 0.02). The goal of the second study was to analyze direct costs induced by cancer from the point of view of the "Mutualité Sociale Agricole", the rural branch of the French Social Security. A 3-year follow-up was the minimum required to be able to isolate costs in function of the different clinical steps of the disease. This study was performed on 24 breast cancers, 16 lung cancers, 22 prostatic cancers and 36 colorectal cancers diagnosed between 1988 and 1991 in patients insured by the Doubs MSA (the rural branch of the French Social Security). The average cost of a cancer varied from 53,800 FF to 82,600 FF, according to cancer site. Transportation costs represented from 7% to 15% of the total cost. These two studies outline the usefulness of cancers registries as a tool for health authorities looking for a better efficiency of the health care system.