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L Mountney

Publications and source records attributed to L Mountney.

6 recordsLinked to original sources
PubMed1992

Importance of district of residence and known primary site for bowel cancer survival: analysis of data from Wessex Cancer Registry.

STUDY OBJECTIVE: The aim was to compare survival with colon and rectal cancer across the 10 districts of Wessex taking into account the age and sex of the individual. DESIGN: The study was based on registrations on the Wessex Cancer Registry between 1979 and 1984 with colon and rectal cancer. Survival up to 31 December 1986 was examined using a Cox regression model; individuals surviving to the end of the follow up period were treated as censored in the analysis. Survival was examined in the first fortnight, the first month, and the first six months after registration separately. PARTICIPANTS: The data comprised 6239 residents of the Wessex Region who had been diagnosed with colon cancer and 3203 residents diagnosed with rectal cancer. For 140 cases survival data or age were missing and these cases were excluded. MEASUREMENTS AND MAIN RESULTS: Results are presented in the format of a league table giving the order of districts from lowest to highest survival rates. No significant differences in survival are found between districts in relation to rectal cancer. We find that one or two districts have consistently high or low survival rates with colon cancer in various periods of follow up, but cannot differentiate between the districts in the centre of the list. Site unspecified is considered as an explanatory variable; it is more predictive than district, and it approaches the importance of age in explaining survival with colon cancer. CONCLUSIONS: There are significant differences in survival with colon cancer between districts; however data on stage at registration are not available and we are unable to say whether the differences in survival are due to differences in stage at diagnosis or differences in survival with similar stage at diagnosis. We found that cases where the site of the cancer within the colon was not recorded on the register have significantly lower survival, and we suggest that site unspecified may be related to stage at diagnosis.

Age Factors↗
PubMed1991

Stage distribution of breast cancer: a basis for the evaluation of breast screening programmes.

Stage at presentation can be predictive of future mortality rates. A change in stage distribution will be indicative of the effect of a programme. All registrations for 1985 aged over 50 years were staged from case notes and, to assess whether a stage drift is already occurring, cases that presented in 1975 were also staged. The accuracy and completeness of the Wessex Cancer Register for this particular cancer was assessed and further sources of registration identified. There was a significant difference between 1975 and 1985 stage distributions. If the Southampton and Salisbury service achieves the same success as the Gavleborg County trials, 4.61 deaths will be prevented at 5 years for each annual cohort of cases. For individual breast screening programmes, effectiveness is better monitored by analysis of stage distribution than of mortality rates.

Breast Neoplasms↗
PubMed1989

Use of a cancer register for monitoring and evaluating a breast cancer screening programme.

To monitor the effectiveness of a breast cancer screening service accurate information is necessary on the incidence of breast cancer before and after screening is introduced. The Wessex Cancer Register has been used to provide data on the incidence prior to screening and arrangements are being made for the exchange of information between the Register and each screening service in Wessex in order that future registrations can be divided into screen-detected and symptomatically-detected cases. Since changes in mortality will not be apparent for some years and are not detectable in small populations, other indicators of effectiveness are required. Stage at presentation predicts mortality; a change in stage distribution as a result of screening would indicate future changes in mortality. The Cancer Register has been used to analyse stage distribution before the advent of screening. Procedures have been adopted for collecting staging data on all breast cancers diagnosed in the future, both within and without the screening service. In this way stage distribution will be compared before and after the implementation of the service and predictions made on the effect on mortality in the future. In addition, information on the incidence of interval cancers will be analysed using the Cancer Register so that, in the long term, an assessment can be made of the appropriate length of the interval between screens. These cancers will be notified to the screening office for review. A Cancer Register can provide the population base from which to measure the true effectiveness of a breast screening service on the community it serves.

Breast Neoplasms↗