Novel quality indicators for metastatic colorectal cancer management identify significant variations in these measures across treatment centers in Australia.

Aims Defining multidisciplinary quality of care indicators ( QCIs) for metastatic colorectal cancer (m CRC) could improve understanding of variations in routine practice care. This may identify areas of below-average performance, which could then be addressed by clinicians to improve the quality of care delivered. This study aimed to define a panel of QCIs in m CRC and, based on these QCIs, to evaluate quality of care across multiple Australian sites. Methods A panel of clinicians with expertise in colorectal cancer defined evidence-based or best practice-based QCIs relevant to the routine multidisciplinary management of m CRC patients through structured consensus discussion. Related data were extracted from the Treatment of Recurrent and Advanced Colorectal Cancer ( TRACC) registry, a prospectively maintained database recording comprehensive details on consecutive m CRC patients across multiple Australian hospitals. Variations in QCIs across sites were explored. Results Of 13 QCIs defined, data related to 10 were reliably extracted from TRACC. Analysis of data on 1276 patients across 10 sites demonstrated low rates of screening for hereditary nonpolyposis colorectal cancer in young patients and significant variation in surveillance-detected recurrences, lung resection rates and palliative chemotherapy use. Exploratory analyses suggested correlation between liver resection rates and survival. Conclusions We have defined a novel set of m CRC QCIs and have demonstrated wide variation in the quality of care of m CRC across multiple Australian sites. With further validation to confirm a direct correlation between QCI and patient outcomes, these QCIs could be applied to improve the quality of care received by all m CRC patients. [ABSTRACT FROM AUTHOR]