Two-year survival of low-grade and high-grade glioma patients using data from the Swedish Cancer Registry

Swedish health care legislation requires equal, high-quality health care for all inhabitants, while regional differences of medical availability and treatment potentially allow for different outcomes. This study was undertaken to evaluate whether glioma survival differed between the Stockholm region and the other Swedish regions since the Stockholm region has easier mean access to regional care and had started a specialized neuro-oncology service for all inhabitants of the region. The Swedish Cancer Registry was searched for all gliomas in the neuroepithelial tissue, aged 16-79 years, and diagnosed between 1996 and the end of 2001. Survival analysis was performed using the Kaplan-Meier method. Survival rates from the Stockholm Regional Cancer Registry area was compared to the other areas in Sweden combined. For high-grade glioma, the 2-year survival was 25% in Stockholm and 14% in the other areas. For low-grade glioma, the 2-year survival was 82% and 72%, respectively. The largest 2-year survival difference was detected for glioblastoma patients aged 16-54 years, with 27% survival in the Stockholm area compared to 12% in the other areas. We cannot rule out all possible bias in our study, but results indicated higher 2-year survival for patients with glioma in the Stockholm region than in other regions of Sweden. These data are incompatible with the legislation of equal health care.