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 are 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 patients with discharge diagnoses of lung, prostate, female breast, and colorectal 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 largely disappeared due to increasing trends among females and decreasing trends among males. During 1988-95, surgeries on the large intestine for colorectal cancer, including right hemicolectomy and sigmoidectomy, decreased significantly, as did abdominoperineal resections of the rectum. Anterior resections 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. Finally, the number and rates of inpatient mastectomies for female breast cancer decreased over the study period (from 219,000 to 180,000 and from 78.8 to 61.5 per 100,000, respectively).

Conclusion: These trends in inpatient surgeries for the major cancers in the US probably reflect changes in disease occurrence and modified treatment recommendations.