Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Quality of care and quality of life for Queensland colorectal cancer patients (#394)

Nathan Dunn 1 , Neal Rawson 1 , John Harrington 1 , John Hansen 2 3 , Pieter Prinsloo 3 4 , David Clark 3 5 , David Taylor 3 5 , Nicholas Lutton 3 6 , Mark Doudle 3 7 , David Theile 3 8
  1. Queensland Cancer Control Analysis Team, Cancer Alliance Queensland, Brisbane, Queensland, Australia
  2. Sunshine Coast University Private Hospital, Birtinya, Queensland, Australia
  3. Colorectal Cancer Sub-committee, Queensland Cancer Control Safety and Quality Partnership, Queensland Health, Brisbane, Queensland, Australia
  4. Cairns Base Hospital, Queensland Health, Cairns, Queensland, Australia
  5. The Royal Brisbane and Women's Hospital, Queensland Health, Brisbane, Queensland, Australia
  6. The Princess Alexandra Hospital, Queensland Health, Brisbane, Queensland, Australia
  7. Pindara Hospital, Gold Coast, Queensland, Australia
  8. Queensland Cancer Control Safety and Quality Partnership, Queensland Health, Brisbane, Queensland, Australia

Aim

To establish a set of clinical indicators to measure the quality of care and quality of life for Queensland patients treated for colorectal cancer.

Methods

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.

Results

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%).

Conclusion

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.