The evaluation of the implementation of “Guidelines of Diagnosis and Treatment for Common Cancers in China (Breast cancer)” in Shanghai / 中国癌症杂志

ABSTRACT

Purpose:To evaluate the effects of the implementation of “Guidelines of Diagnosis and Treatment for Common Cancers in China (Breast cancer)” in recent 10 years, and to provide evidence for decision making for Health Services.Methods:Continuously followed and randomly sampled hospitalized breast cancer cases in District hospitals and General hospitals, evaluated by clinical experts.Results:The rate of total agreement was 41.36%, the rate of essential agreement was 49.09% in 1996-1999. The sum of the two rates was 90.45%. The total agreement rates were without statistical difference among district hospitals, county hospitals and municipal general hospitals. There was no case of disagreement in municipal general hospitals. The disagreement rate in district hospitals went down from 7.69% in 1994 to 3.70% in 1999. The total agreement rate of cases with operation was 46.74%, higher than any group with other treatments. The proportion of cases with correct case stage classification was 47.33%.Conclusions:After implementation of the Guideline, the level of appropriate treatment was increasing. In order to raise the level of cancer diagnosis and treatment, and improve cure rate, survival rate and life quality, we must take measures on staff training, quality control, supportive environment, comprehensive patient management and patient transfer policies.[