Outcomes - Patterns of Care/Quality of Care
It is necessary to understand both the impact of cancer therapy
on the disease and how social factors may influence cancer therapy
itself. Such information is essential to identifying potential areas
for educational programs to improve the quality of treatment. Many
of these programs are planned collaboratively with professional
societies.
The goal of Patterns of Care/Quality of Care (POC/QOC) research
is to evaluate the dissemination of cancer therapy into community
practice, examine possible determinants of on the receipt of cancer
therapies and the relationship between cancer treatment and cancer
outcomes. In addition, NCI has previously used such data to describe
treatment for cancer sites and to compare these descriptions with
the guidelines for care.
In addition to the studies described on The Patterns
of Care/Quality of Care Web site, RRSS investigators are conducting studies to:
- examine the use of alternative medicine among
cancer patients, particularly among head and neck cancer patients
and among ethnic populations of cancer patients in Hawaii;
- investigate differences in breast cancer treatment
and outcomes based on age or geographic variation;
- investigate trends of treatment for in situ
breast cancer and trends regarding the use of radiation therapy;
- determine access to childhood cancer clinical
trials;
- examine the use and costs of medical care services in different
populations, specifically among Native Americans and between different
racial/ethnic groups; and
- define costs of terminal care in hospitals that are directly
attributable to cancer.
Registries Funded to Conduct these Studies
Atlanta (Metropolitan)
Connecticut
Detroit (Metropolitan)
Hawaii
Iowa
Los Angeles
New Mexico
Northern California Cancer Center (SF-OAK)
Seattle (Puget Sound)
Utah
Key Findings
Among women under age 65 with early-stage breast cancer, poverty
rate was not associated with the receipt of, or the recommendation
for, chemotherapy.
After adjusting for age, race/ethnicity, tumor size, and socioeconomic status (SES), the likelihood of receiving
radiotherapy following breast-conserving surgery (BCS) decreased significantly with increasing travel distance
to the nearest radiation-treatment facility.
Female cancer patients were more likely than male cancer patients to use alternative medicine; about 80 percent
of women in the study used at least one type of alternative medicine compared to about 60 percent of men.
Use of alternative medicine among pediatric patients was associated with parental dissatisfaction with their
child's physician. Among pediatric cancer patients involved in the study, 73 percent used at least one alternative
treatment or therapy. However, no patient used alternative medicine as a substitute for standard medical care.
Future Use
The Cancer Care Outcomes Research & Surveillance Consortium
(CanCORS) (UO1 (Cooperative Agreement)) was developed following studies of patterns of care and outcomes
produced using the RRSS mechanism.
|
