Population-based cancer survival in Kuwait

Population-based cancer survival is a key measure of the effectiveness of health systems in managing cancer. Monitoring survival over time and between countries is also crucial to assess inequalities and drive policies for cancer control. In this thesis, I use data from the Kuwait Cancer Registry (KCR) to produce a comprehensive profile of population-based cancer survival in Kuwait, to enable evaluation of cancer care in the country. In order to produce robust population-based net survival estimates, it is necessary to have the full date of both the cancer diagnosis and the last known vital status for all patients. All deaths must be included, irrespective of the cause of death. A new approach to obtain followup data on the vital status of all registered Kuwaiti cancer patients was implemented. This enabled the estimation of population-based cancer survival in Kuwait for the first time, using robust and unbiased methods that allow comparisons to be made over time and between different populations. Further analyses of survival by stage at diagnosis were also performed, to provide a deeper understanding of cancer survival in Kuwait. Finally, an overall assessment of progress against cancer was performed, using the three main cancer control metrics: incidence, survival and mortality. The findings demonstrate that survival has improved for many cancers in Kuwait during 2000-2013. However, further research is required to help dissect the underlying causes of the differences in survival between Kuwait and other countries with comparable income and health systems. It also highlighted the importance of more complete collection of stage data, the necessity of improving early detection, and the need for systematic production and assessment of cancer control measures in Kuwait. The findings should assist policymakers and practitioners investing in the Kuwaiti healthcare system to achieve optimal outcomes and provide guidance towards future research in the country.