Patients with adult-onset cancer who were treated at National Cancer Institute-designated comprehensive cancer centers (NCICCCs) demonstrated greater survival compared to patients treated at non-NCICCCs, according to an article published online in the journal Cancer.
Participants in the study included 69,579 patients who were recently diagnosed with adult onset (22-65 years) cancers in Los Angeles from 1998 to 2008.
Results showed patients receiving treatment at non-NCICCC facilities had lower overall survival than those who were treated at NCICCCs.
These differences were still present after adjusting for clinical and sociodemographic factors (hepatobiliary: HR, 1.5; 95% CI: 1.4,1.7; P<0.001; lung: HR, 1.4; 95% CI: 1.3, 1.6; P<0.001; pancreatic: HR, 1.5; 95% CI: 1.3, 1.7; P<0.001; gastric: HR, 1.3; 95% CI: 1.1, 1.7; P =0.01; breast: HR, 1.3; 95% CI: 1.1, 1.5; P<0.001; and colorectal: HR, 1.2; 95% CI: 1.0, 1.4; P =0.05).
Barriers to care at NCICCCs included race/ethnicity (African-American: OR range across diagnoses: 0.4-0.7; P<0.03; Hispanic: OR range, 0.5-0.7; P<0.04); lack of private insurance (public: OR range, 0.6-0.8; P<0.004; uninsured: OR range, 0.1-0.5; P<0.04); socioeconomic status (high-middle: OR range, 0.4-0.7; P<0.02; middle: OR range, 0.3-0.5; P<0.001; and low: OR range, 0.2-0.6; P<0.01), and residing greater than nine miles from the nearest NCICCC (OR range, 0.5-0.7; P<0.02).
Rigorous processes ensure quality of research and clinical care at National Cancer Institute-designated comprehensive cancer centers (NCICCCs). Unmeasurable elements of structure and process of cancer care delivery warrant evaluation. To the authors’ knowledge, the impact of NCICCC care on survival and access to NCICCCs for vulnerable subpopulations remain unstudied.