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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...

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Autores principales: Carrasco-Peña, Francisco, Bayo-Lozano, Eloisa, Rodríguez-Barranco, Miguel, Petrova, Dafina, Marcos-Gragera, Rafael, Carmona-Garcia, Maria Carmen, Borras, Josep Maria, Sánchez, Maria-José
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
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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.
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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
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