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National Cancer Institute   U.S. National Institutes of
Rapid Response Surveillance Studies
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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)
Detroit (Metropolitan)
Los Angeles
New Mexico
Northern California Cancer Center (SF-OAK)
Seattle (Puget Sound)

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.


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