Patterns of Care POC studies are important to assess how far stateoftheart cancer diagnostics and therapeutics have been disseminated into routine health care The main objectives of the Moroccan POC study covering a period of 10 years 200817 were to document ID: 916410
Download Presentation The PPT/PDF document "Significant efforts were made by the Mor..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
![[Insert Tagline] [Insert or Customize](https://thumbs.docslides.com/633984/insert-tagline-insert-or-customize.jpg)
Slide1
Significant efforts were made by the Moroccan Ministry of Health as part of the National Cancer Control Plan launched in 2010 to improve access to early detection, diagnosis and treatment services, particularly for breast cancer Patterns of Care (POC) studies are important to assess how far state-of-the-art cancer diagnostics and therapeutics have been disseminated into routine health care The main objectives of the Moroccan POC study covering a period of 10 years ( 2008-17) were to document:temporal variations in socio-demographic profile of patients and their tumour characteristicsdelays in accessing diagnosis and treatment, their determinants and trends over timeimprovement in practices related to breast cancer diagnosis and treatmentdisparities in quality of care over time and their impact on disease-free survival for breast cancer
Methods
A retrospective study was conducted at the two largest publicly funded oncology centres: Centre Mohammed VI pour le traitement des cancers (CM-VI) in Casablanca and Institut National d’Oncologie Sidi Mohamed Ben Abdellah (INO) in RabatData were abstracted from the case records of breast cancer patients registered over a two-month period every year starting from 2008 and ending in 2017 A total of 2120 breast cancer patients (915 patients from CM-VI and 1205 patients from INO) were included
Background and objectives
Pattern of care of breast cancer patients in Morocco – a study of variations
in patient & tumour profiles, and quality of care over a decade
Selmouni F
(selmounif@iarc.fr), Mrabti H, Benider A, Bendahhou K, Sauvaget C, Muwonge R, Lucas E, Basu P
Slide2All patientsPeriod of diagnosis2008-2017
(N= 2120)2008-2012
(N= 880)2013-2017(N=1240)P-valueMedian (IQR)Months Median (IQR)Months
Median (IQR)Months
Median interval between the date of onset of symptoms and that of first medical consultation
6 (3-12)
6 (3-12)5 (3-12)<0.001
Median interval between disease confirmation and registration at oncology centre0.6 (0.3-1.7)0.9 (0.5-4.5)0.5 (0.2-1.1)<0.001All patientsPeriod of diagnosis2008-2017(N= 2120)2008-2012(N= 880)
2013
-2017(N=1240)Proportion of patients with complete pathologic staging information 1974 (93%)846 (96%)1128 (91%)Proportion of patients with complete molecular profile (ER/PR/HER2-new)1560 (74%)690 (78%)670 (70%)
Quality of
diagnostic services
Key Outcomes
Table
1: Selected intervals to access healthcare services
Table 2: Availability of information on stage and molecular profile
Slide3All patientsPeriod of diagnosis2008-2017
(N= 2120)
2008-2012(N= 880)2013-2017(N=1240)P-valueMedian (IQR)Months Median (IQR)Months
Median (IQR)Months
Median interval between disease confirmation and initiation of treatment
1.8 (1.0-3.2)
1.6 (0.8-3.8)1.8 (1.0-3.1)0.45
Median interval between the date of surgery and initiation of radiotherapy for the patients who did not receive chemotherapy in between7.3 (4.9 – 9.3)7.1 (5.3-8.9)8.1 (4.1-10.10.51All patientsPeriod of diagnosis2008-20172008-20122013 -2017
Proportion of patients treated appropriately (as per standard of care)
1017/1719
(59.2%)505/725 (69.7%)512/994 (51.5%)Proportion of patients receiving breast conservative therapy when indicated292/516 (56.6%)143/195 (73.3%)149/321 (46.4%)
Proportion of patients receiving adjuvant chemotherapy when indicated
1267/2120 (74%)594/880
(78%)673/1240 (72%)Radiotherapy completed in
3-4 weeks 566/1032 (54.8%
)275/543 (50.6%)
291/489 (59.5%)
2008-2012
2013-2015
P-value
Number at risk
Number of failures Survival proportion%Number at risk Number of failures Survival proportion%Stage I-II (3-year)27640 88.76868 73.3<0.001Stage III-IV (3-year)17711365.427 9348.10.031
Three-year disease-free survival to relapse after treatment among breast cancer patients treated by stage at diagnosis and by period
Key Outcomes
Quality of treatment services
Table
1: Treatment intervals
Table 2
: Selected quality indicators in breast cancer care
Slide4ConclusionSignificant improvement in early diagnosis but decline in quality of care over time possibly due to high patient loadContinued effort is needed to consolidate the gains achieved and address the gaps identified in this studyAcknowledgements
We thank the Lalla Salma Foundation, Prevention and Treatment of cancers for their generous technical and financial support
PublicationsMrabti H et al. Patterns of care of breast cancer patients in Morocco - A study of variations in patient profile, tumour characteristics and standard of care over a decade. Breast. 2021 Oct;59:193-202.IARC; Ministry of Health, Kingdom of Morocco; Lalla Salma Foundation for Cancer Prevention and Treatment (2021). Patterns of care for women with breast cancer in Morocco: an assessment of breast cancer diagnosis, management, and survival in two leading oncology centres. Lyon, France: International Agency for Research on Cancer. Available from: https://publications.iarc.fr/606.