Estimation of an optimal chemotherapy utilisation rate for colon cancer: An evidence-based benchmark for cancer care

Abstract

Background Optimal chemotherapy (CT) utilisation rates can serve as benchmarks to assess the quality of cancer care. This study aims to determine the optimal proportion of patients with colon cancer that should receive chemotherapy at least once. Methods An optimal chemotherapy utilisation tree was constructed using indications for chemotherapy identified from evidence-based treatment guidelines. Data on the proportion of patient and tumour-related attributes for which chemotherapy was indicated were obtained and merged with the treatment indications to calculate an optimal chemotherapy utilisation rate (CTU rate). This optimal rate was compared with reported actual rates of chemotherapy utilisation. Results Chemotherapy is indicated at least once in 55% of patients with colon cancer. While 89% of colon cancer patients presenting with Stage IV disease should optimally receive chemotherapy, 38–52% actually received chemotherapy as part of their initial treatment. Conclusion The optimal chemotherapy utilisation rate can serve as an evidence-based benchmark in the planning and evaluation of chemotherapy services. Chemotherapy may be under-utilised in the initial management of patients presenting with metastatic colon cancer.