NCI Community Cancer Centers Program (NCCCP): Percent improvement in guideline-concordant breast and colon cancer care for disparate patient populations.

Abstract

182 Background: The NCI Community Cancer Center Program (NCCCP) pilot launched in 2007 to improve quality and reduce disparities in patients receiving care in community hospital-based cancer centers. This study assessed the percent improvement in guideline-concordant cancer care since NCCCP initiation, overall and for disparate patient populations. Methods: We conducted a retrospective analysis of patients diagnosed and receiving treatment at one of 12 NCCCP sites. We compared percent improvement in concordance for NQF-approved quality measures: 3 breast (BCS-radiation following breast conserving surgery; HT-hormonal therapy; and MAC-multi-agent chemotherapy) and 2 colon (12RLN-12 regional lymph nodes examined during surgery; and ACT-adjuvant chemotherapy). Sample included patients diagnosed 2006 to 2007 (baseline, or pre-NCCCP) and 2008 to 2013 (NCCCP). Percent improvement was defined as the difference in concordance between baseline and NCCCP periods divided by baseline concordance. Results: Between baseline and NCCCP periods, improvement was noted for all 5 measures. The HT concordance rate improved by 55.1% (from 58.2% to 90.3%). For all breast measures, Black patients showed significantly larger than average percent improvement (p<.05). For BCS and ACT, Medicaid and uninsured patients showed significantly larger than average percent improvement (p<.05). Larger than average improvement was also noted in hospitals in high-poverty markets and in markets with few physicians. Conclusions: The percent of patients receiving guideline concordant breast or colon cancer care increased significantly since Program initiation, particularly among certain disparate patient subgroups. Future analyses will examine issues of disparities in timeliness of treatment.Funded by NCI Contract HHSN261200800001E. [Table: see text]