INTERHOSPITAL DIFFERENCES IN CANCER SURVIVAL - MAGNITUDE AND TREND IN1975-1987 IN OSAKA, JAPAN

This study addresses the disparity in cancer survival rates among hosp itals in Osaka, Japan. Using data from the Osaka Cancer Registry, four -year survival rates for stomach cancer patients (n = 8,845) diagnosed in 1976, 1981 and 1986, and lung cancer (n = 9,795) and breast cancer patients (n = 7,377) diagnosed in 1975-77, 1980-82 and 1985-87 were c alculated according to four hospital categories (teaching hospitals, l arge hospitals: 400+ beds excluding teaching hospitals, medium-size ho spitals: 150-399 beds, and small hospitals: 20-149 beds). Cox's propor tional hazards model was employed with adjustment for sex, age, clinic al stage at diagnosis, and treatment status. Stomach and lung cancer p atients treated in large, medium-size and small hospitals showed signi ficantly higher risks of death than those treated in teaching hospital s in 1975-87. Interhospital differences in breast cancer survival appe ared to increase in 1975-87, whereas those in stomach and lung cancer survivals decreased during the same period.