The Czech Oncological Society strongly objects to the output of the study
On 22 August 2007 the Czech public was informed of puportedly bad results of treatment of oncological diseases in the Czech Rebublic that were published in EUROCARE-4 Study in the Lancet Oncology Journal. This Study compares data on five-year survival of oncological patients diagnosed between 1995 and 1999, together with follow-up observation until 2003, in selected European countries. A related study further brings updated information on survival between the years 2000 and 2002. As concerns the Czech Republic it is a fact that with regard to several oncological diagnoses a relatively low survival rate is cited in comparison to the most advanced European countries.
The Czech Oncological Society strongly objects to the abovementioned output and rejects it in its entirety. Every published output must be assessed and weighed with regard to the input data provided. For the purposes of EUROCARE-4 Study totally irrelevant and unrepresentative data was supplied from the Czech Republic as we will show further on. However it is not the authors of the Study that are to be blamed for this as they worked with data handed over through official channels of our state and had no reason to dispute them as such. The responsibility weighs on the administrator of national oncological data, The Institute of Medical Information and Statistics of the Czech Republic (ÚZIS ČR) or the Ministry of Health of the Czech Republic as the data had to be officially handed over under its affirmation. The official publications of EUROCARE-4 mention Mgr. J. Holub, employee of ÚZIS ČR, as the person responsible for the supplied data. The time schedule shows that the data was transmitted under the former leadership of the Ministry before the 2006 elections. It is very sad that such omissions took place repeatedly as similar problems with Czech data appeared at the time of publication of EUROCARE-3 Study in 2003. Notwithstanding the strong protests of professional oncological society the situation was unfortunately not rectified.
The Czech Republic keeps on a long-term basis (since 1977) its National Oncological Register which is counted amongst the largest and highest quality databases in Europe. Above that it is a representative and complete database as it contains data on all patients for the entire period under consideration. The keeping of this database is prescribed by law and is therefore obligatory. For the whole period under consideration the Register contains more than 1.4 million entries and for the period related to the EUROCARE-4 Study (1995-99) it is more that 270 000 entries. Nevertheless the official background documents for the EUROCARE-4 Study included only Western Bohemia and even that apparently again in an unrepresentative manner. The Study mentions 19 423 supplied entries from this region but in the National Oncological Register there are 24 257 entries for the period 1995-99 and the regions of Pilsen and Karlovy Vary. Similar inconsistencies can be found in the data for the Czech Republic and the continuing analysis for the period of 2000-2002.
A majority of countries included in EUROCARE-4 provided the authors with complete and therefore representative data for the entire population and asserted a 100% coverage of its population. For the Czech Republic EUROCARE-4 mentions only 8% population coverage. The provided data therefore give information only on a very minor part of our register and state. In no case can this data be generalized and deemed representative of the whole republic. The countrywide data that are available on a long-term basis were not provided to the Study. The provision of data was not consulted with the professional society in any way.
The professional oncological society will now take the necessary steps to rectify the situation. Czech oncologists follow on a long-term basis the results of treatment and have at their disposal the data representative of the entire Czech population. These relevant values reach above the European average in a number of oncological diagnoses and therefore also justify the great investments that the Czech Republic is undertaking in the field of oncological treatment. In the table below we present the survival rate values for selected oncological diagnoses, calculated by the same method as was used in the EUROCARE-4 Study. The complete overview of treatment results for all oncological diagnoses was published in March 2007 in the Clinical Oncology Journal and will shortly be available to the public on the website of the oncological society (www.linkos.cz; www.svod.cz).
Results for relative five year survival of oncological patients reached in the Czech Republic (Data for selected diagnoses for the period 1995-2003, valid entries for all types of medical facilities are included, age standardized)* Certain percentage of tumours is diagnosed in a very advanced stage which does not allow antitumour therapy, or this therapy is precluded by the health condition of the patient or by his own refusal to be treated. Analysis conducted on the “all patients” group therefore gives data for the whole population but the real effect of medical facilities can be assessed by looking at the value for patients that have undergone antitumour treatment.
By this statement we primarily seek to stop the dissemination of misinformation about bad treatment of oncological patients in the Czech Republic. This is a very serious matter, from professional and human points of view. There are several hundreds of thousands of oncological patients in our country and these people and their relatives cannot be put under distress by the dissemination of such false startling information. We therefore assert that Czech oncology has in the past fifteen years considerably improved its results and that these now reach the European levels and even slightly surpass European average in a number of diagnoses.
This of course does not mean that problems do not exist. Even today a high number of tumours is detected in a very advanced stage where hope for long-term survival is considerably diminished. But these problems correspond to the situation in any other European country. The professional oncological society in co-operation with the current leadership of the Ministry of Health of the Czech Republic will take all the measures needed in order to reliably inform the Czech public and in order to make sure that such serious and wrong interpretation of national data is not repeated.
prof. MUDr. Jiří Vorlíček, CSc.
President of the Czech Oncological Society ČLS JEP
prof. MUDr. Jitka Abrahámová, DrSc.
President of the Council of National Oncological Register of the Czech Republic
doc. RNDr. Ladislav Dušek, Ph.D.
Director of Institute of Biostatistics and Analyses of Masaryk University Brno
Brno on 24 August 2007
Information and links regarding the subject
- Statement of Ministry of Health of the Czech Republic on the level of oncological care in the Czech Republic
- Supplement of Clinical Oncology Journal March 2007 issue, contains full overview of results of treatment for all oncological diagnoses
- Results of EUROCARE-4 Study were published in the journal Lancet Oncology as an early online publication(the full text article will show only to subscribers of the journal). Accessible also to users of ScienceDirect service.
- Web portal SVOD: Epidemiology of malignant tumours in the Czech Republic interprets data from the National Oncological Register and makes them available to the general public.