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Atlas nº 6

Variability in
in the National Health System, 2005-2007



In this Atlas we describe the differences across surgery utilisation in the treatment of 9 cancer types: breast, bladder, colorectal, prostate, uterus, larynx, lung, stomach and esophagus, between the years 2005 and 2007.

The variability found is different depending on the cancer studied, being maximum for prostate and lung surgery, intermediate when dealing with esophagus, stomach, bladder and larynx, and minimum in the case of colorectal, breast and uterus cancer.

It is precisely in those cases where more variability exists, where differences seem not to be amenable to cancer epidemiology, but to the fact of living in a particular geographic zone or living in sanitary areas with a given socioeconomic level. The availability of hospital resources did not seem to have any influence in the number of surgical interventions.

The variability patterns suggest that the differences found would relate with the following factors: degree of scientific agreement on the efficiency of the screening for a certain cancer as well as surgery effectiveness, degree of utilisation of population screening programs or opportunistic screening, the differences in professional criterion in relation to tumour resectability and the difficulties in accessing to an early diagnostics linked to socioeconomic differences. The variability pattern was specific regarding the combination of these factors in each type of tumour.











  Instituto de Salud Carlos III        


 Step 2: Variations in oncological surgery  Step 3: Demand Factors associated to Variability  Step 4: Offer Factors associated to Variability  Step 5: Implications
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