or search on
|Title:||Concordance with national guidelines for colorectal cancer care in New South Wales: a population-based patterns of care study|
|Keywords:||Aged; Design; drug therapy; Female; Guideline Adherence; Guidelines; Hospitals; Humans; Male; Meta-Analysis; methods; Aged,80 and over; Middle Aged; Multicenter Studies; New South Wales; Outcome Assessment (Health Care); Patient Compliance; Patterns of care; Population Surveillance; Practice Guidelines; Prospective Studies; Questionnaires; Antineoplastic Agents; radiotherapy; Radiotherapy,Adjuvant; Registries; Research; Risk Factors; Societies,Medical; standards; surgery; therapeutic use; therapy; cancer; Wales; cancer registry; Colectomy; Colon; colorectal cancer; Colorectal Neoplasms|
|Journal Title:||Med J Aust|
|Page number start:||292|
|Page number end:||295|
|Abstract:||OBJECTIVE: To investigate predictors of evidence-based surgical care in a population-based sample of patients with newly diagnosed colorectal cancer. DESIGN, PATIENTS AND SETTING: Prospective audit of all new patients with colorectal cancer reported to the New South Wales Central Cancer Registry between 1 February 2000 and 31 January 2001. MAIN OUTCOME MEASURES: Concordance with seven guidelines from the 1999 Australian evidence-based guidelines for colorectal cancer; predictors of guideline concordance; the mean proportion of relevant guidelines followed for individual patients. RESULTS: Questionnaires were received for 3095 patients (91.6%). Between 0 and 100% of relevant guidelines were followed for individual patients (median, 67%). Concordance with individual guidelines varied considerably. Patient age independently predicted non-concordance with guidelines for adjuvant therapy and preoperative radiotherapy. Adjuvant chemotherapy was more likely if a patient with node-positive colon cancer was treated in a metropolitan hospital or by a general surgeon. Surgeons with a high caseload or specialty in colorectal cancer were more likely to perform colonic pouch reconstruction, prescribe thromboembolism or antibiotic prophylaxis, and were less likely to refer patients with high-risk rectal cancer for adjuvant radiotherapy. Bowel preparation was less likely among older patients and in high-caseload hospitals. CONCLUSION: Effective strategies to fully implement national colorectal cancer guidelines are needed. In particular, increasing the use of appropriate adjuvant therapy should be a priority, especially among older people|
|Programme:||Health Services Research; Colorectal Cancer|
|Division:||Cancer Research Division|
|Appears in Collections:||Research Articles|
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.