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Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain

Author

Listed:
  • Francisco Carrasco-Peña

    (Radiation Oncology Department, University Hospital Virgen Macarena, 41009 Sevilla, Spain)

  • Eloisa Bayo-Lozano

    (Radiation Oncology Department, University Hospital Virgen Macarena, 41009 Sevilla, Spain)

  • Miguel Rodríguez-Barranco

    (Escuela Andaluza de Salud Pública, 18011 Granada, Spain
    Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
    CIBER de Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain)

  • Dafina Petrova

    (Escuela Andaluza de Salud Pública, 18011 Granada, Spain
    Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
    CIBER de Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain)

  • Rafael Marcos-Gragera

    (CIBER de Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
    Medical Sciences Department, Faculty of Medicine, University of Girona (UdG), 17071 Girona, Spain
    Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Department of Health, Government of Catalonia, 17007 Girona, Spain
    Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute—IDIBGI, Salt, 17190 Girona, Spain)

  • Maria Carmen Carmona-Garcia

    (Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute—IDIBGI, Salt, 17190 Girona, Spain
    Medical Oncology Department, Catalan Institute of Oncology, University Hospital Dr Josep Trueta, 17007 Girona, Spain)

  • Josep Maria Borras

    (Department of Clinical Sciences, IDIBELL, University of Barcelona, Hospitalet, 08908 Barcelona, Spain
    Department of Health, Catalonian Cancer Strategy, Hospitalet, 08908 Barcelona, Spain)

  • Maria-José Sánchez

    (Escuela Andaluza de Salud Pública, 18011 Granada, Spain
    Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
    CIBER de Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
    Department of Preventive Medicine and Public Health, University of Granada, 18010 Granada, Spain)

Abstract

Colorectal cancer (CRC) is the third most common cancer worldwide. Population-based, high-resolution studies are essential for the continuous evaluation and updating of diagnosis and treatment standards. This study aimed to assess adherence to clinical practice guidelines and investigate its relationship with survival. We conducted a retrospective high-resolution population-based study of 1050 incident CRC cases from the cancer registries of Granada and Girona, with a 5-year follow-up. We recorded clinical, diagnostic, and treatment-related information and assessed adherence to nine quality indicators of the relevant CRC guidelines. Overall adherence (on at least 75% of the indicators) significantly reduced the excess risk of death (RER) = 0.35 [95% confidence interval (CI) 0.28–0.45]. Analysis of the separate indicators showed that patients for whom complementary imaging tests were requested had better survival, RER = 0.58 [95% CI 0.46–0.73], as did patients with stage III colon cancer who underwent adjuvant chemotherapy, RER = 0.33, [95% CI 0.16–0.70]. Adherence to clinical practice guidelines can reduce the excess risk of dying from CRC by 65% [95% CI 55–72%]. Ordering complementary imagining tests that improve staging and treatment choice for all CRC patients and adjuvant chemotherapy for stage III colon cancer patients could be especially important. In contrast, controlled delays in starting some treatments appear not to decrease survival.

Suggested Citation

  • Francisco Carrasco-Peña & Eloisa Bayo-Lozano & Miguel Rodríguez-Barranco & Dafina Petrova & Rafael Marcos-Gragera & Maria Carmen Carmona-Garcia & Josep Maria Borras & Maria-José Sánchez, 2020. "Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain," IJERPH, MDPI, vol. 17(18), pages 1-15, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6697-:d:413545
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    References listed on IDEAS

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    1. Paul W. Dickman & Enzo Coviello, 2015. "Estimating and modeling relative survival," Stata Journal, StataCorp LP, vol. 15(1), pages 186-215, March.
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    Cited by:

    1. Antonio Sarría-Santamera & Alua Yeskendir & Tilektes Maulenkul & Binur Orazumbekova & Abduzhappar Gaipov & Iñaki Imaz-Iglesia & Lorena Pinilla-Navas & Teresa Moreno-Casbas & Teresa Corral, 2021. "Population Health and Health Services: Old Challenges and New Realities in the COVID-19 Era," IJERPH, MDPI, vol. 18(4), pages 1-5, February.

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