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Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain
- Source :
- International Journal of Environmental Research and Public Health, Vol 17, Iss 6697, p 6697 (2020), Dipòsit Digital de la UB, Universidad de Barcelona, International Journal of Environmental Research and Public Health, 2020, vol. 17, núm. 18, p. 6697, Articles publicats (D-CM), DUGiDocs – Universitat de Girona, instname, International Journal of Environmental Research and Public Health, Volume 17, Issue 18, Digibug. Repositorio Institucional de la Universidad de Granada, Digibug: Repositorio Institucional de la Universidad de Granada, Universidad de Granada (UGR)
- Publication Year :
- 2020
- Publisher :
- MDPI AG, 2020.
-
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&ndash<br />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&ndash<br />0.73], as did patients with stage III colon cancer who underwent adjuvant chemotherapy, RER = 0.33, [95% CI 0.16&ndash<br />0.70]. Adherence to clinical practice guidelines can reduce the excess risk of dying from CRC by 65% [95% CI 55&ndash<br />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.
- Subjects :
- Male
Colorectal cancer
Health, Toxicology and Mutagenesis
lcsh:Medicine
High resolution
0302 clinical medicine
Medicine
adherence
030212 general & internal medicine
cancer survival
Rectum -- Cancer
High-resolution study
education.field_of_study
Absolute risk reduction
Clinical Practice
Estudi de casos
population-based study
030220 oncology & carcinogenesis
Female
Guideline Adherence
Colorectal Neoplasms
Clinical practice guidelines
clinical practice guidelines
medicine.medical_specialty
Population
colorectal cancer
Article
03 medical and health sciences
Càncer colorectal
Internal medicine
Humans
education
Neoplasm Staging
Retrospective Studies
Population-based study
high-resolution study
business.industry
lcsh:R
Public Health, Environmental and Occupational Health
Cancer
medicine.disease
Cancer survival
Confidence interval
Population based study
Spain
Adherence
Case studies
Recte -- Càncer
business
Subjects
Details
- ISSN :
- 16604601
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- International Journal of Environmental Research and Public Health
- Accession number :
- edsair.doi.dedup.....43d30ff641a706cefe8eb7da4bc9858f