TABLE C-1 Examples of Cancer Care Quality Studies Using State Cancer Registry Data (published in the last 10 years)

Author

State/Topic

Design

Conclusion

Comments

Wanebo HJ, Cole B, Chung M, et al. Is Surgical Management Compromised in Elderly Patients with Breast Cancer? Annals of Surgery 225(5):579–589, 1997.

Rhode Island

Patterns of care associated with age among women treated surgically for breast cancer

Screening and treatment patterns assessed for 5,962 women diagnosed with breast cancer between 1987 and 1995 identified through the state registry (study limited to the 9 institutions using AJCC tumor classification). Descriptive statistics for treatment by age and stage (no comorbidity measures).

Breast cancer management is compromised in the elderly.

Detection rate of preinvasive cancers in women 65+ was 8.8% vs. 13.7% for women 40–65. Lumpectomy alone was done in 25.0% of elderly patients with stage I cancer vs. 9.5% in patients 40–65. Lumpectomy alone was done in 9.5% of stage II and 10.6% of stage III in patients 65+ vs. 2.7% and 2.2%, respectively, in younger patients.

The study was not population-based and was limited to those institutions with AJCC tumor classification.

No data on comorbidity. available.

Adams-Cameron M, Gilliland FD, Hunt WC, et al. Trends in Incidence and Treatment for Ductal Carcinoma in Situ in Hispanic, American Indian, and Non-Hispanic White Women in New Mexico, 1973–1994. Cancer 85(5):1084–1090, 1999.

New Mexico

Patterns of care associated with race/ ethnicity among women with ductal carcinoma in situ (DCIS)

Treatment patterns assessed for 950 cases of DCIS identified through the state cancer registry from 1973 to 1994. Patient characteristics included: age at diagnosis, ethnicity, residence, and poverty status (as determined by census tract of residence). Physician characteristics included: age, gender, specialty, volume of surgical breast carcinoma patients, and location of treatment.

The use of BCS for DCIS increased to 52% by 1994. Geographic location of treatment was the most significant predictor of treatment. Other patient and provider characteristics were not related to use of breast-conserving surgery (BCS).

The variation in rates of BCS by treatment location most likely reflects differences in physician practices and treatment recommendations.



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