Innovations in health care and mortality trends from five cancers in seven European countries between 1970 and 2005.

Rasmus Hoffmann, Iris Plug, Martin McKee, Bernadette Khoshaba, Ragnar Westerling, Caspar Looman, Gregoire Rey, Eric Jougla, Katrin Lang, Kersti Pärna, Johan P. Mackenbach 2013. International Journal of Public Health, 59(2):341-50.

Objectives Although the contribution of health care to
survival from cancer has been studied extensively, much
less is known about its contribution to population health.
We examine how medical innovations have influenced
trends in cause-specific mortality at the national level.
Methods Based on literature reviews, we selected six
innovations with proven effectiveness against cervical
cancer, Hodgkin’s disease, breast cancer, testicular cancer,
and leukaemia. With data on the timing of innovations and
cause-specific mortality (1970–2005) from seven European
countries we identified associations between innovations
and favourable changes in mortality.
Results For none of the five specific cancers, sufficient
evidence for an association between introduction of innovations
and a positive change in mortality could be found.
The highest association was found between the introduction
of Tamoxifen and breast cancer mortality.
Conclusions The lack of evidence of health care effectiveness
may be due to gradual improvements in treatment,
to effects limited to certain age groups or cancer subtypes,
and to contemporaneous changes in cancer incidence.
Research on the impact of health care innovations on
population health is limited by unreliable data on their

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