An assessment of cancer centre level designation and guideline adherent care in those with rectal cancer: A population based retrospective cohort study
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Le résumé fourni par la source
BACKGROUND: Institutions providing care to individuals with cancer are organized based on available resources and treatments offered. It is presumed that increasing levels of care will result in improved quality of care and outcomes. The objective is to determine whether Cancer Level Designation is associated with guideline adherent care and/or survival. METHODS: This is a retrospective study of individuals within the Ontario Rectal Cancer Cohort, a population-level database including all adults undergoing surgical resection for rectal cancer between 2010 - 2019 were included in Ontario, Canada. The primary exposure was Cancer Centre Level Designation as defined by Cancer Care Ontario (i.e., Level 1/2 = regional cancer center; Level 3 = affiliate cancer center; Level 4 = satellite cancer center). The primary outcomes were guideline adherent care and survival. Associations were determined using one-way analysis of variances and a multivariable Cox proportional hazards model. RESULTS: 12,399 patients were included with 54 % from a Level 1/2 centre, 33 % from a Level 3 centre and 13 % from a Level 4+ centre. All assessed aspects of guideline adherent care were associated with cancer centre level designation. Unadjusted 5-year overall survival was associated with cancer centre level designation (Level 1/2 79.5 % vs. Level 3 79.1 % vs. Level 4/non-designated 75.4 %, P = 0.003). Adjusted Cox Proportional Hazard Analysis for overall survival found the following: Level 4/5 HR 1.11 (95 %CI 0.99 - 1.25); Level 3 HR 1.01 (95 % CI 0.93 - 1.11); Level 1/2 1 [Referent group]. CONCLUSIONS: Increasing Cancer Centre Level Designation was associated with higher likelihood of receiving the appropriate investigations and treatments in those with rectal cancer and may also be associated with survival. POLICY SUMMARY: Future work should consider the centralization of complex rectal cancer care as well as quality improvement initiatives aimed at enhancing guideline adherent care across all centres managing rectal cancer.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- An assessment of cancer centre level designation and guideline adherent care in those with rectal cancer: A population based retrospective cohort study
- Date Crossref
- 01/12/2024
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Queens University Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Kingston Health Sciences Centre pays non établi dans la noticeÉtablissement de santé
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McMaster University Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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John Radcliffe Hospital pays non établi dans la noticeÉtablissement de santé
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University of Oxford pays non établi dans la noticeUniversité ou école supérieure
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Queen's University pays non établi dans la noticeUniversité ou école supérieure
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Queens Cancer Research Institute Cancer Care Epidemiology pays non établi dans la noticeStructure de recherche
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Oxford University Nuffield Department of Primary Care Health Sciences pays non établi dans la noticeUniversité ou école supérieure
Department of Surgery — Queens University, Kingston Health Sciences Centre et Department of Surgery — McMaster University, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.