Stable overall referral rates of primary radiotherapy for newly diagnosed cancer patients in the ageing population of South-Eastern Netherlands, 1975–1998

Abstract

Background and purpose To determine the primary radiotherapy (RT) consumption in a population of almost one million inhabitants, served by one RT centre. Primary RT was defined as being planned, started or finished within 4–6 months of diagnosis. Application was evaluated according to tumour category, stage and year of diagnosis during three 8-year periods: 1975–1982, 1983 –1990 and 1991–1998. Results Most patients were between 60 and 75 years. The number of patients receiving primary RT increased with 3% annually over the whole studied period, but remained proportionally stable for males at 30% and decreased for females from 36.2 to 34.6%. A decrease of referral rates for patients with gynaecological cancer was observed. The introduction of breast-conserving therapy in 1981 and of population screening for women aged 50–69 years in 1992 led to a considerable increase of primary RT. The eightfold increase in number of irradiated patients with localised prostate cancer rather reflected a higher detection rate than an increased referral rate. Except for an important increase of irradiated patients with rectal cancer, largely due to the shift to preoperative RT since 1994, and of patients with brain cancer, only slight alterations in referral rates were observed for the other cancers. Conclusions Use of primary RT remained proportionally steady and modest. The marked increase in workload was mainly due to more and earlier detection of breast and prostate cancer and treatment changes in rectal cancer. Decreases were observed for each of the gynecological cancers.