Patterns of inpatient surgeries for the top four cancers in the United States, National Hospital Discharge Survey, 1988-95

Background: At a time when the population is aging and medical practices ar e rapidly changing, ongoing surveillance of surgical treatments for cancer is valuable for health services planning. Methods: We used data from the National Hospital Discharge Survey for patie nts with discharge diagnoses of lung, prostate, female breast, and colorect al cancer during 1988-95 to estimate population-based rates and numbers of inpatient surgical procedures. Results: In 1988-91, rates of lobectomy for lung cancer were significantly higher in males than females. By 1994-95, the male/female differences had l argely disappeared due to increasing trends among females and decreasing tr ends among males. During 1988-95, surgeries on the large intestine for colo rectal cancer, including right hemicolectomy and sigmoidectomy, decreased s ignificantly, as did abdominoperineal resections of the rectum. Anterior re sections of the rectum increased significantly. Radical prostatectomies for prostate cancer increased from 34,000 in 1988-89 to 104,000 in 1992-93 and then decreased to 87,000 in 1994-95; rates followed a similar pattern. Fin ally, the number and rates of inpatient mastectomies for female breast canc er decreased over the study period (from 219,000 to 180,000 and from 78.8 t o 61.5 per 100,000, respectively). Conclusion: These trends in inpatient surgeries for the major cancers in th e US probably reflect changes in disease occurrence and modified treatment recommendations.