Cargando…
Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain
Colorectal cancer (CRC) is the third most common cancer worldwide. Population-based, high-resolution studies are essential for the continuous evaluation and updating of diagnosis and treatment standards. This study aimed to assess adherence to clinical practice guidelines and investigate its relatio...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558406/ https://www.ncbi.nlm.nih.gov/pubmed/32938004 http://dx.doi.org/10.3390/ijerph17186697 |
_version_ | 1783594634904076288 |
---|---|
author | Carrasco-Peña, Francisco Bayo-Lozano, Eloisa Rodríguez-Barranco, Miguel Petrova, Dafina Marcos-Gragera, Rafael Carmona-Garcia, Maria Carmen Borras, Josep Maria Sánchez, Maria-José |
author_facet | Carrasco-Peña, Francisco Bayo-Lozano, Eloisa Rodríguez-Barranco, Miguel Petrova, Dafina Marcos-Gragera, Rafael Carmona-Garcia, Maria Carmen Borras, Josep Maria Sánchez, Maria-José |
author_sort | Carrasco-Peña, Francisco |
collection | PubMed |
description | Colorectal cancer (CRC) is the third most common cancer worldwide. Population-based, high-resolution studies are essential for the continuous evaluation and updating of diagnosis and treatment standards. This study aimed to assess adherence to clinical practice guidelines and investigate its relationship with survival. We conducted a retrospective high-resolution population-based study of 1050 incident CRC cases from the cancer registries of Granada and Girona, with a 5-year follow-up. We recorded clinical, diagnostic, and treatment-related information and assessed adherence to nine quality indicators of the relevant CRC guidelines. Overall adherence (on at least 75% of the indicators) significantly reduced the excess risk of death (RER) = 0.35 [95% confidence interval (CI) 0.28–0.45]. Analysis of the separate indicators showed that patients for whom complementary imaging tests were requested had better survival, RER = 0.58 [95% CI 0.46–0.73], as did patients with stage III colon cancer who underwent adjuvant chemotherapy, RER = 0.33, [95% CI 0.16–0.70]. Adherence to clinical practice guidelines can reduce the excess risk of dying from CRC by 65% [95% CI 55–72%]. Ordering complementary imagining tests that improve staging and treatment choice for all CRC patients and adjuvant chemotherapy for stage III colon cancer patients could be especially important. In contrast, controlled delays in starting some treatments appear not to decrease survival. |
format | Online Article Text |
id | pubmed-7558406 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-75584062020-10-22 Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain Carrasco-Peña, Francisco Bayo-Lozano, Eloisa Rodríguez-Barranco, Miguel Petrova, Dafina Marcos-Gragera, Rafael Carmona-Garcia, Maria Carmen Borras, Josep Maria Sánchez, Maria-José Int J Environ Res Public Health Article Colorectal cancer (CRC) is the third most common cancer worldwide. Population-based, high-resolution studies are essential for the continuous evaluation and updating of diagnosis and treatment standards. This study aimed to assess adherence to clinical practice guidelines and investigate its relationship with survival. We conducted a retrospective high-resolution population-based study of 1050 incident CRC cases from the cancer registries of Granada and Girona, with a 5-year follow-up. We recorded clinical, diagnostic, and treatment-related information and assessed adherence to nine quality indicators of the relevant CRC guidelines. Overall adherence (on at least 75% of the indicators) significantly reduced the excess risk of death (RER) = 0.35 [95% confidence interval (CI) 0.28–0.45]. Analysis of the separate indicators showed that patients for whom complementary imaging tests were requested had better survival, RER = 0.58 [95% CI 0.46–0.73], as did patients with stage III colon cancer who underwent adjuvant chemotherapy, RER = 0.33, [95% CI 0.16–0.70]. Adherence to clinical practice guidelines can reduce the excess risk of dying from CRC by 65% [95% CI 55–72%]. Ordering complementary imagining tests that improve staging and treatment choice for all CRC patients and adjuvant chemotherapy for stage III colon cancer patients could be especially important. In contrast, controlled delays in starting some treatments appear not to decrease survival. MDPI 2020-09-14 2020-09 /pmc/articles/PMC7558406/ /pubmed/32938004 http://dx.doi.org/10.3390/ijerph17186697 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Carrasco-Peña, Francisco Bayo-Lozano, Eloisa Rodríguez-Barranco, Miguel Petrova, Dafina Marcos-Gragera, Rafael Carmona-Garcia, Maria Carmen Borras, Josep Maria Sánchez, Maria-José Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain |
title | Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain |
title_full | Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain |
title_fullStr | Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain |
title_full_unstemmed | Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain |
title_short | Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain |
title_sort | adherence to clinical practice guidelines and colorectal cancer survival: a retrospective high-resolution population-based study in spain |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558406/ https://www.ncbi.nlm.nih.gov/pubmed/32938004 http://dx.doi.org/10.3390/ijerph17186697 |
work_keys_str_mv | AT carrascopenafrancisco adherencetoclinicalpracticeguidelinesandcolorectalcancersurvivalaretrospectivehighresolutionpopulationbasedstudyinspain AT bayolozanoeloisa adherencetoclinicalpracticeguidelinesandcolorectalcancersurvivalaretrospectivehighresolutionpopulationbasedstudyinspain AT rodriguezbarrancomiguel adherencetoclinicalpracticeguidelinesandcolorectalcancersurvivalaretrospectivehighresolutionpopulationbasedstudyinspain AT petrovadafina adherencetoclinicalpracticeguidelinesandcolorectalcancersurvivalaretrospectivehighresolutionpopulationbasedstudyinspain AT marcosgragerarafael adherencetoclinicalpracticeguidelinesandcolorectalcancersurvivalaretrospectivehighresolutionpopulationbasedstudyinspain AT carmonagarciamariacarmen adherencetoclinicalpracticeguidelinesandcolorectalcancersurvivalaretrospectivehighresolutionpopulationbasedstudyinspain AT borrasjosepmaria adherencetoclinicalpracticeguidelinesandcolorectalcancersurvivalaretrospectivehighresolutionpopulationbasedstudyinspain AT sanchezmariajose adherencetoclinicalpracticeguidelinesandcolorectalcancersurvivalaretrospectivehighresolutionpopulationbasedstudyinspain |