Indicators based on registers and administrative data for breast cancer: routine evaluation of oncologic care pathway can be implemented

Abstract

It is possible to evaluate the quality of cancer care delivered in clinical practice in recent years, in order to implement interventions aimed to improve adherence to international standards of care.

Compliance with clinical guidelines for breast cancer management: A population-based study of quality-of-care indicators in France

“…Moreover, guidelines were not followed for metastatic work-up: imaging was performed too often in early BC (stages I-II) and not enough often in stage III BC. These observations have already been reported in several studies [17,38,39]. Guidelines recommend imaging only for patients with symptomatic early BC and stage III BC because the reported probability of occult distant metastasis in stage I-II BC is exceedingly low (0.3–1.2%) [3,4,38].…”

“…The recent hospital-based European studies found similar rates (94–98%) [22,23,25,26] while lower rates (92–93%) were observed in the Norwegian and Slovenian population-based [28,29]. Older studies found also lower rates [11–13,15,17,20]. In the US, radiotherapy after BCS was less frequent (80%) with geographic disparities [16,34,35].…”

“…Several studies were conducted before 2003, when guidelines and treatments differed than those currently in use. Out of all recent studies [9–29], the only few conducted at the population level [9–12,16,17,28,29] used recent data (after 2010) [28,29]. Five studies using EUSOMA QIs [22,24–27] were hospital-based and included patients from voluntary centers (often EUSOMA certified centers [22,24–26]), which may introduce selection biases and overestimate compliance.…”

“…Another French study found perfect compliance, probably due to patient selection (i.e., operable early-stage BC patients managed in CCC, TH and general hospitals) [27]. Older studies found lower compliance rates (60–70%) [10,11,17], except for one study that excluded elderly patients [12].…”

Intensive follow-up for women with breast cancer: review of clinical, economic and patient’s preference domains through evidence to decision framework

“…Their recommendations would fall under the definition of a “less intensive follow-up” that, in the majority of the studies included in our review, would include at least a clinical visit and mammography once a year. However, intensive follow-up is still also quite common in clinical practice [ 48 – 51 ] and represents a significant workload for radiotherapy, surgery and oncology professionals [ 10 ], in addition to being a costly process.…”