To establish a set of clinical indicators to measure the quality of care and quality of life for Queensland patients treated for colorectal cancer.
The Queensland Oncology Repository (QOR) compiles and collates administrative and clinical data from the Queensland Cancer Registry together with hospital admissions, treatment and mortality data. We utilised clinical feedback to create 12 quality indicators comparing treatment practice and outcomes in Queensland hospitals for colorectal cancer patients diagnosed between 2005-2014.
Standard indicators reporting treatment rates were complemented with quality of care indicators, constructed by extracting appropriate colorectal surgical and other procedural codes delivered within specified timeframes.
Between 2010-2014, 80% of colon cancer patients and 77% of rectal cancer patients underwent major resection (MR). One-third (35%) of rectal cancer patients undergoing MR were treated with neo-adjuvant radiation therapy. Adjuvant IV systemic therapy was delivered to 53% of stage III colon cancer patients and 60% of stage III rectal cancer patients.
The rate of MR being conducted laparoscopically increased by more than 50% over ten years for both colon and rectal cancers (45% in 2010-2014). Fewer than 20% of laparoscopic surgeries were converted to open surgery during 2014.
Stoma at resection was more common among rectal patients (56%) than colon patients (8%). Rectal patients receiving a non-permanent stoma were less likely to be living with a stoma at one year (23%) and five years (11%) than colon patients (57%; 36%).
It is possible to utilise clinical expertise to derive meaningful measures of the quality of colorectal cancer treatment from existing sources of routine admitted patient data which extends beyond basic treatment rates. Data can also be utilised to create meaningful measures of quality of life for colorectal cancer patients. Reporting these outcomes allows comparisons with other jurisdictions and sets a baseline to enable prospective monitoring of colorectal cancer care in Queensland.