Background
Methods
Setting
Patient population and data collection
Defining outcome, exposure and covariates
Statistical analysis
Results
Before CPP | During CPP | After CPP | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | Non-CPP referred | CPP referred | ||||||||
n | (%) | n | (%) | n | (%) | n | (%) | n | (%) | |
Total | 1202 | (100) | 4187 | (100) | 2336 | (100) | 1564 | (100) | 772 | (100) |
Deaths in three years | 695 | (57.8) | 2208 | (52.7) | 1165 | (49.9) | 775 | (49.6) | 390 | (50.5) |
Survival rate (raw) | ||||||||||
1 year | 0.592 | 0.647 | 0.671 | 0.669 | 0.675 | |||||
3 years | 0.413 | 0.471 | 0.501 | 0.505 | 0.495 | |||||
Sex | ||||||||||
Woman | 624 | (51.9) | 2120 | (50.6) | 1128 | (48.3) | 782 | (50.0) | 346 | (44.8) |
Man | 578 | (48.1) | 2067 | (49.4) | 1208 | (51.7) | 782 | (50.0) | 426 | (55.2) |
Age, median (IQI) | 68 | (58–77) | 68 | (59–76) | 68 | (59–76) | 68 | (59–76) | 68 | (60–76) |
Age groups (years) | ||||||||||
18–44 | 84 | (7.0) | 258 | (6.2) | 141 | (6.0) | 102 | (6.5) | 39 | (5.1) |
45–54 | 138 | (11.5) | 469 | (11.2) | 264 | (11.3) | 191 | (12.2) | 73 | (9.5) |
55–64 | 293 | (24.4) | 1040 | (24.8) | 549 | (23.5) | 353 | (22.6) | 196 | (25.4) |
65–74 | 337 | (28.0) | 1235 | (29.5) | 724 | (31.0) | 472 | (30.2) | 252 | (32.6) |
75- | 350 | (29.1) | 1185 | (28.3) | 658 | (28.2) | 446 | (28.5) | 212 | (27.5) |
Diagnoses | ||||||||||
CRC | 283 | (23.5) | 1073 | (25.6) | 629 | (26.9) | 405 | (25.9) | 224 | (29.0) |
Lung | 280 | (23.3) | 1018 | (24.3) | 501 | (21.4) | 299 | (19.1) | 202 | (26.2) |
Melanoma | 125 | (10.4) | 403 | (9.6) | 236 | (10.1) | 154 | (9.8) | 82 | (10.6) |
Head & neck | 74 | (6.2) | 260 | (6.2) | 180 | (7.7) | 141 | (9.0) | 39 | (5.1) |
Upper GI | 185 | (15.4) | 570 | (13.6) | 336 | (14.4) | 252 | (16.1) | 84 | (10.9) |
Gynaecological | 141 | (11.7) | 484 | (11.6) | 250 | (10.7) | 186 | (11.9) | 64 | (8.3) |
Urinary system | 114 | (9.5) | 379 | (9.1) | 204 | (8.7) | 127 | (8.1) | 77 | (10.0) |
Tumour stage | ||||||||||
Local | 452 | (37.6) | 1530 | (36.5) | 868 | (37.2) | 596 | (38.1) | 272 | (35.2) |
Regional | 219 | (18.2) | 807 | (19.3) | 458 | (19.6) | 289 | (18.5) | 169 | (21.9) |
Distant | 330 | (27.5) | 1294 | (30.9) | 719 | (30.8) | 462 | (29.5) | 257 | (33.3) |
Unknown/missing | 201 | (16.7) | 556 | (13.3) | 291 | (12.5) | 217 | (13.9) | 74 | (9.6) |
Comorbidity | ||||||||||
None | 793 | (66.0) | 2913 | (69.6) | 1.636 | (70.0) | 1.064 | (68.0) | 572 | (74.1) |
Moderate | 319 | (26.5) | 1051 | (25.1) | 563 | (24.1) | 394 | (25.2) | 169 | (21.9) |
High | 90 | (7.5) | 223 | (5.3) | 137 | (5.9) | 106 | (6.8) | 31 | (4.0) |
Educational level | ||||||||||
Low | 473 | (39.4) | 1874 | (44.8) | 897 | (38.4) | 587 | (37.5) | 310 | (40.2) |
Medium | 421 | (35.0) | 1450 | (34.6) | 883 | (37.8) | 601 | (38.4) | 282 | (36.5) |
High | 202 | (16.8) | 641 | (15.3) | 456 | (19.5) | 307 | (19.6) | 149 | (19.3) |
Missing | 106 | (8.8) | 222 | (5.3) | 100 | (4.3) | 69 | (4.4) | 31 | (4.0) |
Household income | ||||||||||
Low | 378 | (31.4) | 1323 | (31.6) | 778 | (33.3) | 505 | (32.3) | 273 | (35.4) |
Medium | 363 | (30.2) | 1364 | (32.6) | 802 | (34.3) | 542 | (34.7) | 260 | (33.7) |
High | 395 | (32.9) | 1360 | (32.5) | 753 | (32.2) | 513 | (32.8) | 239 | (31.0) |
Survival and excess mortality across the time of CPP implementation
Before CPP | During CPP | After CPP | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | Non-CPP referred | CPP referred | ||||||||
RS | (95%CI) | RS | (95%CI) | RS | (95%CI) | RS | (95%CI) | RS | (95%CI) | |
CRC | 79.5 | (74.0;84.0) | 80.9 | (78.1;83.4) | 82.0 | (78.4;85.0) | 82.9 | (78.4;86.5) | 80.1 | (74.0;85.7) |
Lung | 31.7 | (26.6;36.9) | 38.7 | (35.4;42.0) | 43.7 | (39.6;47.8) | 40.5 | (35.4;45.6) | 48.7 | (41.7;55.3) |
Melanoma | 93.9 | (87.7;97.0) | 96.9 | (93.9;98.5) | 96.5 | (92.2;98.4) | 97.9 | (90.9;99.5) | 92.9 | (83.7;97.0) |
Head & neck | 77.1 | (63.5;87.1) | 87.3 | (80.5;91.8) | 83.1 | (75.2;88.7) | 86.8 | (78.0;92.2) | 70.0 | (52.5;82.1) |
Upper GI | 31.3 | (24.9;38.0) | 38.5 | (34.6;42.3) | 38.6 | (33.4;43.8) | 37.6 | (31.6;43.5) |
a
| |
Gynaecological | 76.9 | (68.5;83.3) | 84.7 | (80.7;87.9) | 90.7 | (85.5;94.1) | 89.3 | (82.7;93.5) | 95.3 | (84.3;98.7) |
Urinary system | 65.8 | (56.4;73.6) | 74.1 | (69.1;78.4) | 77.3 | (69.7;83.2) | 73.7 | (64.1;81.2) |
a
| |
Total | 60.7 | (57.8;63.4) | 66.5 | (65.0;68.0) | 69.0 | (67.1;70.9) | 68.7 | (66.3;70.9) | 69.8 | (66.4;73.0) |
Before CPP | During CPP | After CPP | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | Non-CPP referred | CPP referred | ||||||||
RS | (95%CI) | RS | (95%CI) | RS | (95%CI) | RS | (95%CI) | RS | (95%CI) | |
CRC | 63.8 | (57.0;69.9) | 66.4 | (62.9;69.7) | 69.3 | (64.8;73.3) | 70.8 | (65.2;75.7) | 65.4 | (57.6;72.1) |
Lung | 11.3 | (8.00;15.4) | 16.2 | (13.7;18.9) | 20.4 | (15.6;25.7) | 19.5 | (13.6;26.2) | 20.9 | (15.5;26.9) |
Melanoma | 89.6 | (81.5;94.3) | 91.7 | (87.4;94.5) | 91.9 | (86.1;95.4) | 95.6 | (87.0;98.5) | 85.3 | (74.2;91.8) |
Head & neck | 57.0 | (41.5;69.8) | 70.3 | (61.6;77.4) | 73.6 | (64.1;81.0) | 77.8 | (66.8;85.6) | 58.5 | (39.2;73.6) |
Upper GI | 18.5 | (13.5;24.2) | 19.8 | (16.5;23.3) | 18.5 | (14.5;22.9) | 17.4 | (12.9;22.5) |
a
| |
Gynaecological | 58.3 | (48.7;66.8) | 70.7 | (67.1;77.4) | 75.2 | (68.2;80.8) | 72.8 | (64.5;79.5) | 84.4 | (70.8;92.0) |
Urinary system | 47.7 | (38.5;56.3) | 59.9 | (54.2;65.1) | 61.7 | (53.1;69.3) | 59.2 | (48.6;68.4) |
a
| |
Total | 44.5 | (41.5;47.5) | 51.0 | (49.4;52.6) | 54.4 | (52.2;56.5) | 54.5 | (51.8;57.1) | 54.1 | (50.3;57.8) |
Before CPP | During CPP | After CPP | ||||||
---|---|---|---|---|---|---|---|---|
Total | CPP referred | |||||||
EHR | (95%CI) | EHR | (95%CI) | EHR | (95%CI) | EHR | (95%CI) | |
CRC | 1.02 | (0.69;1.51) | 1.04 | (0.80;1.34) | 1 | ref | 1.15 | (0.76;1.75) |
Lung | 1.11 | (0.90;1.37) | 1.01 | (0.87;1.17) | 1 | ref |
0.73
| (0.57;0.94) |
Melanoma | 1.13 | (0.21;5.79) | 0.84 | (0.24;2.94) | 1 | ref | 0.62 | (0.09;4.35) |
Head & neck | 1.74 | (0.82;3.67) | 1.03 | (0.55;1.94) | 1 | ref | 1.22 | (0.44;3.33) |
Upper GI | 1.24 | (0.97;1.59) | 0.94 | (0.78;1.13) | 1 | ref | 0.96 | (0.68;1.34) |
Gynaecological |
2.60
| (1.37;4.94) | 1.29 | (0.75;2.22) | 1 | ref | 0.47 | (0.11;1.97) |
Urinary system | 1.59 | (0.96;2.66) | 0.95 | (0.64;1.41) | 1 | ref | 0.51 | (0.25;1.06) |
Total |
1.25
| (1.10;1.43) | 0.99 | (0.90;1.10) | 1 | ref | 0.86 | (0.73;1.01) |
Before CPP | During CPP | After CPP | ||||||
---|---|---|---|---|---|---|---|---|
Total | CPP referred | |||||||
EHR | (95%CI) | EHR | (95%CI) | EHR | (95%CI) | EHR | (95%CI) | |
CRC | 1.16 | (0.87;1.57) | 1.11 | (0.91;1.36) | 1 | ref | 1.13 | (0.81;1.57) |
Lung |
1.30
| (1.09;1.55) | 1.13 | (0.99;1.28) | 1 | ref |
0.77
| (0.62;0.95) |
Melanoma | 1.11 | (0.48;2.55) | 0.64 | (0.31;1.32) | 1 | ref | 1.97 | (0.65;5.97) |
Head & Neck | 2.12 | (1.26;3.56) | 1.25 | (0.79;1.97) | 1 | ref | 1.36 | (0.62;2.98) |
Upper GI | 1.15 | (0.92;1.43) | 0.93 | (0.79;1.10) | 1 | ref | 1.00 | (0.74;1.34) |
Gynaecological |
1.99
| (1.29;3.07) | 1.15 | (0.81;1.65) | 1 | ref | 0.81 | (0.40;1.62) |
Urinary system | 1.49 | (0.98;2.26) | 0.93 | (0.68;1.27) | 1 | ref | 0.67 | (0.40;1.12) |
Total |
1.35
| (1.21;1.51) | 1.06 | (0.98;1.15) | 1 | ref | 0.91 | (0.79;1.04) |