Impact of care at comprehensive cancer centers on outcome: Results from a population‐based study

BACKGROUND Rigorous processes ensure quality of research and clinical care at National Cancer Institute‐designated comprehensive cancer centers (NCICCCs). Unmeasurable elements of structure and process of cancer care delivery warrant evaluation. To the authors' knowledge, the impact of NCICCC c...

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Bibliographic Details
Published in:Cancer 2015-11, Vol.121 (21), p.3885-3893
Main Authors: Wolfson, Julie A., Sun, Can‐Lan, Wyatt, Laura P., Hurria, Arti, Bhatia, Smita
Format: Article
Language:English
Subjects:
Adult
Aged
cancer
Cancer Care Facilities - statistics & numerical data
cancer centers
Cohort Studies
Delivery of Health Care - standards
Female
Health Impact Assessment - statistics & numerical data
Humans
Male
Middle Aged
National Cancer Institute
National Cancer Institute (U.S.)
Neoplasms - mortality
Neoplasms - therapy
Outcome Assessment (Health Care) - statistics & numerical data
outcomes
Quality of Health Care - standards
Retrospective Studies
Survival Rate
Treatment Outcome
United States
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Summary:BACKGROUND Rigorous processes ensure quality of research and clinical care at National Cancer Institute‐designated comprehensive cancer centers (NCICCCs). Unmeasurable elements of structure and process of cancer care delivery warrant evaluation. To the authors' knowledge, the impact of NCICCC care on survival and access to NCICCCs for vulnerable subpopulations remain unstudied. METHODS The current study's population‐based cohort of 69,579 patients had newly diagnosed adult‐onset (aged 22‐65 years) cancers reported to the Los Angeles County cancer registry between 1998 and 2008. Geographic information systems were used for geospatial analysis. RESULTS With regard to overall survival across multiple diagnoses, patients not receiving their first planned treatment at NCICCCs experienced poorer outcomes compared with those treated at NCICCCs; differences persisted on multivariable analyses after adjusting for clinical and sociodemographic factors (hepatobiliary: hazard ratio [HR], 1.5; 95% confidence interval [95% CI], 1.4‐1.7 [P
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.29576