Quality indicators of clinical cancer care for prostate cancer: a population-based study in southern Switzerland

Abstract

BackgroundQuality of cancer care (QoCC) has become an important item for providers, regulators and purchasers of care worldwide. Aim of this study is to present the results of some evidence-based quality indicators (QI) for prostate cancer (PC) at the population-based level and to compare the outcomes with data available in the literature.MethodsThe study included all PC diagnosed on a three years period analysis (01.01.2011–31.12.2013) in the population of Canton Ticino (Southern Switzerland) extracted from the Ticino Cancer Registry database. 13 QI, approved through the validated Delphi methodology, were calculated using the “available case” approach: 2 for diagnosis, 4 for pathology, 6 for treatment and 1 for outcome. The selection of the computed QI was based on the availability of medical documentation. QI are presented as proportion (%) with the corresponding 95% confidence interval.Results700 PC were detected during the three-year period 2011–2013: 78.3% of them were diagnosed through a prostatic biopsy and for 72.5% 8 or more biopsy cores were taken. 46.5% of the low risk PC patients underwent active surveillance, while 69.2% of high risk PC underwent a radical treatment (radical prostatectomy, radiotherapy or brachytherapy) and 73.5% of patients with metastatic PC were treated with hormonal therapy. The overall 30-day postoperative mortality was 0.5%.ConclusionsResults emerging from this study on the QoCC for PC in Canton Ticino are encouraging: the choice of treatment modalities seems to respect the international guidelines and our results are comparable to the scarce number of available international studies. Additional national and international standardisation of the QI and further QI population-based studies are needed in order to get a real picture of the PC diagnostic-therapeutic process progress through the definition of thresholds of minimal standard of care.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4604-2) contains supplementary material, which is available to authorized users.

Quality of Care for Prostate Cancer in Kashmir, India: A Real-World Study

“…A set of QI representing crucial facets of the care given to patients diagnosed with PC was used by our research team, encompassing the clinical domains of diagnosis, pathology, and treatment. The QI were selected from a comprehensive list developed and validated by other researchers [ 6 , 10 , 11 ]. Further, the staging of the disease was registered based on the American Joint Committee on Cancer (AJCC) staging manual (8th edition) [ 12 ].…”

“…QoC studies can typically assess the quality of care provided at the societal level, providing an accurate picture of the regional care pattern, free of sample bias. This could be done using the information from the cancer registries [ 6 ]. It is possible to document the quality of treatment delivered and offer regular feedback to healthcare professionals and decision-makers through specific quality indicators (QI), which are used for QoC studies [ 6 ].…”

“…This could be done using the information from the cancer registries [ 6 ]. It is possible to document the quality of treatment delivered and offer regular feedback to healthcare professionals and decision-makers through specific quality indicators (QI), which are used for QoC studies [ 6 ]. The QoC can be broadly evaluated based on three categories of QI, viz., structure, process, and outcome indicators [ 7 ].…”

Establishing metastatic prostate cancer quality indicators using a modified Delphi approach

“…In the Ticino Cancer Registry in Switzerland, one QI in their 13 PCa-related QIs focussed on men with mPCa. 3 They reported that 73.5% of patients with mPCa received androgen deprivation therapy (ADT) within 3 months of diagnosis. In the Danish registry, the sole indicator regarding men with mPCa demonstrated that 52% of patients in 2014 were receiving ADT within 6 months of diagnosis, 4 much lower than their pre-determined standard of ≥75% 4 .…”

“…† 2 All men with metastatic PCa should have performance status recorded at an MDT meeting 3. In men with metastatic PCa, clinicians should screen for the presence of symptoms including pain, psychosocial distress (e.g.…”