The National Cancer Institute Community Cancer Centers Program (NCCCP): Sustaining Quality and Reducing Disparities in Guideline-Concordant Breast and Colon Cancer Care

Spain, Pamela; Teixeira-Poit, Stephanie; Halpern, Michael T.; Castro, Kathleen; Das, Irene Prabhu; Adjei, Brenda A.; Lewis, Rebecca S.; Clauser, Steven B.

doi:10.1634/theoncologist.2016-0252

Cited by 12 publications

(6 citation statements)

References 4 publications

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“…Currently, more than 75% of breast cancer care is delivered in community hospitals, and it thus is important that this study capture this model of care. 12,13 A limitation of this study was the small sample in each cohort (41 NC patients, 32 CTX patients). Small sample sizes can lead to insufficient power, thus increasing the likelihood of type 2 errors.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, more than 75% of breast cancer care is delivered in community hospitals, and it thus is important that this study capture this model of care. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…Because more than 75% of the surgical care for breast cancer in the United States is delivered in community hospitals, the experience of the impact that COVID-19 has on breast cancer care at our institution reflects the majority of breast cancer care across the nation. 12,13 This study aimed to capture the changes made in the multidisciplinary care of breast cancer patients in a community hospital during the initial phases of the COVID-19 pandemic. The study also sought to assess whether these changes were associated with negative reactions from patients related to their overall mental health, breast cancer care, and outlook.…”

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confidence: 99%

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COVID-19 Pandemic: Changes in Care for a Community Academic Breast Center and Patient Perception of Those Changes

et al. 2021

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Background Philadelphia and its suburbs were an epicenter for the initial COVID-19 outbreak. Accordingly, alterations were made in breast cancer care at a community hospital. Methods The authors developed a prospective database of all the patients with invasive or in situ breast cancer between March 1 and June 15 at their breast center. Any change in a breast cancer plan due to the pandemic was documented, and the patients were grouped into two cohorts according to whether a change was made (CTX) or no change was made (NC) in their care. The patients were asked a series of questions about their care, including those in the Generalized Anxiety Disorder two-item questionnaire (GAD-2), via telephone. Results The study enrolled 73 patients: 41 NC patients (56%) and 32 CTX patients (44%). The two cohorts did not differ in terms of age, race, or stage. Changes included delay in therapy (15.1%) and use of neoadjuvant endocrine therapy (NET, 28.8%). The median time to surgery was 24 days (interequartile range [IQR], 16–45 days) for the NC patients and 82 day s (IQR, 52–98 days) for the CTX patients ( p ≤ 0.001). The median duration of NET was 78 days. The GAD-2 showed anxiety positivity to be 29.6% for the CTX patients and 32.4% for the NC patients ( p = 1.00). More than half (55.6%) of the CTX patients believed COVID-19 affected their treatment outlook compared with 25.7% of the NC patients ( p = 0.021). Conclusions A prospective database captured changes in breast cancer care at a community academic breast center during the initial phase of the COVID-19 pandemic. 44% of patients experienced a change in breast cancer care due to COVID-19. The same level of anxiety and depression was seen in both change in therapy (CTX) and no change (NC). 55.6% of CTX cohort believed COVID-19 affected their treatment outlook.

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Section: Discussionmentioning

confidence: 99%

“…Currently, more than 75% of breast cancer care is delivered in community hospitals, and it thus is important that this study capture this model of care. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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COVID-19 Pandemic: Changes in Care for a Community Academic Breast Center and Patient Perception of Those Changes

et al. 2021

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“…There were also lower rates of guideline-concordance among uninsured patients, although this did not reach statistical significance. Uninsured patients may have inadequate healthcare access, low rates of healthcare utilization, or be unable to pay for follow-up tests out-ofpocket [23][24][25]. Additionally, uninsured patients often have low health literacy and difficulty navigating the healthcare system [26].…”

Section: Discussionmentioning

confidence: 99%

Patient characteristics associated with adherence to pulmonary nodule guidelines

Iaccarino

Steiling

Slatore

et al. 2020

Respiratory Medicine

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Hospital Accreditation Status and Treatment Differences Among Black Patients With Colon Cancer

Chan,

Palis,

Cotler

et al. 2024

JAMA Netw Open

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ImportanceHospital-level factors, such as hospital type or volume, have been demonstrated to play a role in treatment disparities for Black patients with cancer. However, data evaluating the association of hospital accreditation status with differences in treatment among Black patients with cancer are lacking.ObjectiveTo evaluate the association of Commission on Cancer (CoC) hospital accreditation status with receipt of guideline-concordant care and mortality among non-Hispanic Black patients with colon cancer.Design, Setting, and ParticipantsThis population-based cohort study used the National Program of Cancer Registries, which is a multicenter database with data from all 50 states and the District of Columbia, and covers 97% of the cancer population in the US. The participants included non-Hispanic Black patients aged 18 years or older diagnosed with colon cancer between January 1, 2018, and December 31, 2020. Race and ethnicity were abstracted from medical records as recorded by health care facilities and practitioners. The data were analyzed from December 7, 2023, to January 17, 2024.ExposureCoC hospital accreditation.Main Outcome and MeasuresGuideline-concordant care was defined as adequate lymphadenectomy during surgery for patients with stages I to III disease or chemotherapy administration for patients with stage III disease. Multivariable logistic regression models investigated associations with receipt of guideline-concordant care and Cox proportional hazards regression models assessed associations with 3-year cancer-specific mortality.ResultsOf 17 249 non-Hispanic Black patients with colon cancer (mean [SD] age, 64.8 [12.8] years; 8724 females [50.6%]), 12 756 (74.0%; mean [SD] age, 64.7 [12.8] years) were treated at a CoC-accredited hospital and 4493 (26.0%; mean [SD] age, 65.1 [12.5] years) at a non–CoC-accredited hospital. Patients treated at CoC-accredited hospitals compared with those treated at non–CoC-accredited hospitals had higher odds of receiving guideline-concordant lymphadenectomy (adjusted odds ratio [AOR], 1.89; 95% CI, 1.69-2.11) and chemotherapy (AOR, 2.31; 95% CI, 1.97-2.72). Treatment at CoC-accredited hospitals was associated with lower cancer-specific mortality for patients with stages I to III disease who received surgery (adjusted hazard ratio [AHR], 0.87; 95% CI, 0.76-0.98) and for patients with stage III disease eligible for chemotherapy (AHR, 0.75; 95% CI, 0.59-0.96).Conclusions and RelevanceIn this cohort study of non-Hispanic Black patients with colon cancer, patients treated at CoC-accredited hospitals compared with those treated at non–CoC-accredited hospitals were more likely to receive guideline-concordant care and have lower mortality risk. These findings suggest that increasing access to high-quality guideline-concordant care at CoC-accredited hospitals may reduce variations in cancer treatment and outcomes for underserved populations.

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The National Cancer Institute Community Cancer Centers Program (NCCCP): Sustaining Quality and Reducing Disparities in Guideline-Concordant Breast and Colon Cancer Care

Cited by 12 publications

References 4 publications

COVID-19 Pandemic: Changes in Care for a Community Academic Breast Center and Patient Perception of Those Changes

COVID-19 Pandemic: Changes in Care for a Community Academic Breast Center and Patient Perception of Those Changes

Patient characteristics associated with adherence to pulmonary nodule guidelines

Hospital Accreditation Status and Treatment Differences Among Black Patients With Colon Cancer

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