Between-hospital variations in 3-year survival among patients with newly diagnosed gastric, colorectal, and lung cancer

Abstract

Due to increases in cancer survivability, quality assessments of cancer care must include long-term outcomes. This multicenter retrospective cohort study evaluated between-hospital variations in the 3-year survival rates of patients with gastric, colorectal, and lung cancer irrespective of treatment modality. We linked cancer registry data and administrative data from patients aged 18–99 years who were diagnosed with gastric, colorectal, or lung cancer between 2013 and 2015 in Osaka Prefecture, Japan. The 3-year survival rates were adjusted for potential prognostic factors using multilevel logistic regression models. Between-hospital variations were visually evaluated using funnel plots. We analyzed 10,296 gastric cancer patients from 30 hospitals, 9276 colorectal cancer patients from 30 hospitals, and 7978 lung cancer patients from 28 hospitals. The 3-year survival rate was 70.2%, 75.2%, and 45.0% for gastric, colorectal, and lung cancer, respectively. In the funnel plots, the adjusted survival rates of gastric and colorectal cancer for all hospitals lay between the lower and upper control limits of two standard deviations of the average survival rates. However, the adjusted survival rates of lung cancer for four hospitals lay below the lower limit while that for two hospitals lay above the upper limit. Older age, men, advanced cancer stage, comorbidities, functional disability, emergency admission, current/ex-smokers, and underweight were independently associated with poorer survival. In conclusion, there were between-hospital variations in 3-year survival for lung cancer even after adjusting for case mix. Quality improvement initiatives may be needed to raise the consistency of care.

Breast Cancer Care Pathways for Women with Preexisting Severe Mental Disorders: Evidence of Disparities in France?

“…In addition to whether women had a preexisting SMI, we adjusted for other variables that may influence cancer care pathways, including socioeconomic status, overall health state, and characteristics of the hospital where care was received, which may influence treatment choice and mortality [ 54 , 55 , 56 , 57 ].…”

Patterns of staging, treatment, and mortality in gastric, colorectal, and lung cancer among older adults with and without preexisting dementia: a Japanese multicentre cohort study

“…First, clinical data from a hospital-based cancer registry were linked with administrative data produced by hospitals for reimbursements under Japan's Diagnosis Procedure Combination/Per-Diem Payment System. The details of this record-linked database have been reported previously [19][20][21][22][23][24][25][26]. Briefly, the hospital-based cancer registry collects patient demographic information, as well as information on the diagnosis and treatment of newly diagnosed cancer cases; this includes the date of diagnosis, topographical and morphological codes based on the International Classification of Diseases for Oncology Third Edition (ICD-O-3), cancer stage at the time of diagnosis based on the Seventh Edition of the Union for International Cancer Control staging system, and cancer treatment modality.…”

Socioeconomic disparities in cancer survival: Relation to stage at diagnosis, treatment, and centralization of patients to accredited hospitals, 2005–2014, Japan

“…Recent studies demonstrated that patients who underwent surgery at the national or prefectural ACHs had higher 3-year survival than their counterparts who were treated at nondesignated hospitals, 21 and that survival rates of patients with common solid cancers did not differ across ACHs after adjusting for case mix. 22 While several studies support the effectiveness of the current cancer control measures in improving populationlevel survival, 21,22 it remains understudied as to whether such measures could also address the existing socioeconomic disparities in cancer care and survival. In light of the above, the objectives of the present study are to (1) describe socioeconomic disparities and their trends in cancer care and survival, and (2) examine the extent to which socioeconomic disparities in cancer survival are explained by factors that are relevant to cancer control measures (i.e., promoting early-stage detection, standardizing treatment, and centralizing patients to ACHs) in Japan.…”

“…Recent studies demonstrated that patients who underwent surgery at the national or prefectural ACHs had higher 3‐year survival than their counterparts who were treated at non‐designated hospitals, 21 and that survival rates of patients with common solid cancers did not differ across ACHs after adjusting for case mix. 22 …”

“…As of 2020 in Osaka, the third most populated prefecture in Japan, a total of 66 (17 national and 49 prefectural) ACHs were allocated throughout the prefecture. Recent studies demonstrated that patients who underwent surgery at the national or prefectural ACHs had higher 3‐year survival than their counterparts who were treated at non‐designated hospitals, 21 and that survival rates of patients with common solid cancers did not differ across ACHs after adjusting for case mix 22 …”