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Abstract Background Cancer is the second most common cause of death in Germany, and treatment in certified cancer networks is recommended to ensure high-quality care. This study sought to (1) determine the percentage of all primary tumors that might potentially have been treated in certified cancer networks and (2) assess the development and current state of quality-assured cancer care for all cancer patients from a locally defined region in Upper Franconia, Germany. Methods This study was a population-centered retrospective cohort analysis based on data from the Bavarian Cancer Registry (2017–2023). First, we determined all potentially available cancer network certifications and calculated the percentage of cancer care that could potentially have been conducted in certified cancer networks. Second, we considered the certification status of the involved healthcare providers and analyzed whether or not cancer care was actually carried out in certified cancer networks. Results Overall, 90.1% (62,119/68,973) of all primary tumors, from a total of 63,372 patients, might potentially have been treated in certified cancer networks. The percentage of patients actually receiving care in certified cancer center networks was 40.7% for initial diagnosis, 59.0% for surgery, 53.2% for chemotherapy, and 50.7% for radiotherapy; the weighted mean was 50.3%. The results thus ranged between 46.9% (2023) and 52.8% (2022). The highest proportions of patients who received quality-assured treatment in certified cancer center networks were determined for breast cancer (79.5%), colon cancer (73.1%), and lymphoma (60.1%); in contrast, the lowest results were shown for lung cancer (2.7%), anal cancer (0.0%), and mesothelioma (0.0%). Female patients as well as younger patients were significantly more likely to receive care in certified care networks compared with their counterparts. In addition, we did not find a clear trend whether patients in different tumor stages were more or less likely to receive care in certified care networks. Conclusions We found meaningful differences in the proportion of patients who received quality-assured treatment in certified cancer center networks. Following this, patients should receive comprehensive information about receiving care in certified cancer center networks and consider longer travel distances, especially for those cancer types without locally available certified cancer networks.

Background: Cancer is the second most common cause of death in Germany, and treatment in certified cancer networks is recommended to ensure high-quality care. This study sought to (1) determine the percentage of all primary tumors that might potentially have been treated in certified cancer networks and (2) assess the development and current state of quality-assured cancer care for all cancer patients from a locally defined region in Upper Franconia, Germany. Methods: This study was a population-centered retrospective cohort analysis based on data from the Bavarian Cancer Registry (2017–2023). First, we determined all potentially available cancer network certifications and calculated the percentage of cancer care that could potentially have been conducted in certified cancer networks. Second, we considered the certification status of the involved healthcare providers and analyzed whether or not cancer care was actually carried out in certified cancer networks. Results: Overall, 90.1% (62,119/68,973) of all primary tumors, from a total of 63,372 patients, might potentially have been treated in certified cancer networks. The percentage of patients actually receiving care in certified cancer center networks was 40.7% for initial diagnosis, 59.0% for surgery, 53.2% for chemotherapy, and 50.7% for radiotherapy; the weighted mean was 50.3%. The results thus ranged between 46.9% (2023) and 52.8% (2022). The highest proportions of patients who received quality-assured treatment in certified cancer center networks were determined for breast cancer (79.5%), colon cancer (73.1%), and lymphoma (60.1%); in contrast, the lowest results were shown for lung cancer (2.7%), anal cancer (0.0%), and mesothelioma (0.0%). Female patients as well as younger patients were significantly more likely to receive care in certified care networks compared with their counterparts. In addition, we did not find a clear trend whether patients in different tumor stages were more or less likely to receive care in certified care networks. Conclusions: We found meaningful differences in the proportion of patients who received quality-assured treatment in certified cancer center networks. Following this, patients should receive comprehensive information about receiving care in certified cancer center networks and consider longer travel distances, especially for those cancer types without locally available certified cancer networks. [ABSTRACT FROM AUTHOR]

Simple Summary: Certification in oncology aims to establish structural and procedural standards according to evidence-based guidelines. The WiZen study is the largest study so far to analyze the effect of the certification of designated cancer centers on survival in Germany. Based on clinical cancer registry data of 47.440 colorectal cancer patients treated between 2009 and 2017, the present study shows that treatment at colorectal cancer centers has been associated with significantly better outcomes. Patients treated at certified facilities had an eleven percent (colon)/nine percent (rectum) lower risk of dying within the first five years after diagnosis. These findings support the shift towards a more structured cancer care system. (1) Background: The WiZen study is the largest study so far to analyze the effect of the certification of designated cancer centers on survival in Germany. This certification program is provided by the German Cancer Society (GCS) and represents one of the largest oncologic certification programs worldwide. Currently, about 50% of colorectal cancer patients in Germany are treated in certified centers. (2) Methods: All analyses are based on population-based clinical cancer registry data of 47.440 colorectal cancer (ICD-10-GM C18/C20) patients treated between 2009 and 2017. The primary outcome was 5-year overall survival (OAS) after treatment at certified cancer centers compared to treatment at other hospitals; the secondary endpoint was recurrence-free survival. Statistical methods included Kaplan–Meier analysis and multivariable Cox regression. (3) Results: Treatment at certified hospitals was associated with significant advantages concerning 5-year overall survival (HR 0.92, 95% CI 0.89, 0.96, adjusted for a broad range of confounders) for colon cancer patients. Concentrating on UICC stage I–III patients, for whom curative treatment is possible, the survival benefit was even larger (colon cancer: HR 0.89, 95% CI 0.84, 0.94; rectum cancer: HR 0.91, 95% CI 0.84, 0.97). (4) Conclusions: These results encourage future efforts for further implementation of the certification program. Patients with colorectal cancer should preferably be directed to certified centers. [ABSTRACT FROM AUTHOR]

Abstract Background Treatment of cancer patients in certified cancer centers, that meet specific quality standards in term of structures and procedures of medical care, is a national treatment goal in Germany. However, convincing evidence that treatment in certified cancer centers is associated with better outcomes in patients with pancreatic cancer is still missing. Methods We used patient-specific information (demographic characteristics, diagnoses, treatments) from German statutory health insurance data covering the period 2009–2017 and hospital characteristics from the German Standardized Quality Reports. We investigated differences in survival between patients treated in hospitals with and without pancreatic cancer center certification by the German Cancer Society (GCS) using the Kaplan–Meier estimator and Cox regression with shared frailty. Results The final sample included 45,318 patients with pancreatic cancer treated in 1,051 hospitals (96 GCS-certified, 955 not GCS-certified). 5,426 (12.0%) of the patients were treated in GCS-certified pancreatic cancer centers. Patients treated in certified and non-certified hospitals had similar distributions of age, sex, and comorbidities. Median survival was 8.0 months in GCS-certified pancreatic cancer centers and 4.4 months in non-certified hospitals. Cox regression adjusting for multiple patient and hospital characteristics yielded a significantly lower hazard of long-term, all-cause mortality in patients treated in GCS-certified pancreatic centers (Hazard ratio = 0.89; 95%-CI = 0.85–0.93). This result remained robust in multiple sensitivity analyses, including stratified estimations for subgroups of patients and hospitals. Conclusion This robust observational evidence suggests that patients with pancreatic cancer benefit from treatment in a certified cancer center in terms of survival. Therefore, the certification of hospitals appears to be a powerful strategy to improve patient outcomes in pancreatic cancer care. Trial registration ClinicalTrials.gov ( NCT04334239 ).

Background: Treatment of cancer patients in certified cancer centers, that meet specific quality standards in term of structures and procedures of medical care, is a national treatment goal in Germany. However, convincing evidence that treatment in certified cancer centers is associated with better outcomes in patients with pancreatic cancer is still missing.Methods: We used patient-specific information (demographic characteristics, diagnoses, treatments) from German statutory health insurance data covering the period 2009-2017 and hospital characteristics from the German Standardized Quality Reports. We investigated differences in survival between patients treated in hospitals with and without pancreatic cancer center certification by the German Cancer Society (GCS) using the Kaplan-Meier estimator and Cox regression with shared frailty.Results: The final sample included 45,318 patients with pancreatic cancer treated in 1,051 hospitals (96 GCS-certified, 955 not GCS-certified). 5,426 (12.0%) of the patients were treated in GCS-certified pancreatic cancer centers. Patients treated in certified and non-certified hospitals had similar distributions of age, sex, and comorbidities. Median survival was 8.0 months in GCS-certified pancreatic cancer centers and 4.4 months in non-certified hospitals. Cox regression adjusting for multiple patient and hospital characteristics yielded a significantly lower hazard of long-term, all-cause mortality in patients treated in GCS-certified pancreatic centers (Hazard ratio = 0.89; 95%-CI = 0.85-0.93). This result remained robust in multiple sensitivity analyses, including stratified estimations for subgroups of patients and hospitals.Conclusion: This robust observational evidence suggests that patients with pancreatic cancer benefit from treatment in a certified cancer center in terms of survival. Therefore, the certification of hospitals appears to be a powerful strategy to improve patient outcomes in pancreatic cancer care.Trial Registration: ClinicalTrials.gov ( NCT04334239 ). [ABSTRACT FROM AUTHOR]

Introduction: Oncological second opinions are becoming increasingly important in the era of complex treatments and established certified cancer centers. Oncological guidelines with the highest levels of evidence are available, but these can only be effective to the extent that they are implemented. Therefore, we analyzed the effects of second opinions with regard to their agreement with first opinions and conformity with guidelines. Methods: In 164 patients with a diagnosis of breast cancer or gynecological malignancy who requested a second opinion, the first and second opinions, established at the interdisciplinary tumor conference, and conformity with the guidelines were evaluated. Results: The first opinion was not in agreement with the guidelines in 34.8% (15.2% diagnosis, 12.8% surgical therapy, 13.4% systemic therapy, and 5.5% radiotherapy), and the recommendations were optimized in the second opinion in 56.7% (28.7% diagnosis, 15.9% surgical therapy, 30.5% systemic therapy, and 8.5% radiotherapy). Conclusions: Oncological second opinions showed significant effects and one-third of first opinions were not in conformity with the guidelines. In a significant proportion of cases, the existing treatment plan was changed or supplemented to allow modern and individualized treatment approaches. [ABSTRACT FROM AUTHOR]