Prevalence and characteristics of cancer patients receiving care from single vs. multiple institutions

Patients may receive cancer care from multiple institutions. However, at the population level, such patterns of cancer care are poorly described, complicating clinical research. To determine the population-based prevalence and characteristics of patients seen by multiple institutions, we used operations data from a state-mandated cancer registry.

59,672 invasive cancers diagnosed in 1/1/2010-12/31/2011 in the Greater Bay Area of northern California were categorized as having been reported to the cancer registry within 365days of diagnosis by: 1) ≥1 institution within an integrated health system (IHS); 2) IHS institution(s) and ≥1 non-IHS institution (e.g., private hospital); 3) 1 non-IHS institution; or 4) ≥2 non-IHS institutions. Multivariable logistic regression was used to characterize patients reported by multiple vs. single institutions.

Overall in this region, 17% of cancers were reported by multiple institutions. Of the 33% reported by an IHS, 8% were also reported by a non-IHS. Of non-IHS patients, 21% were reported by multiple institutions, with 28% for breast and 27% for pancreatic cancer, but 19%% for lung and 18% for prostate cancer. Generally, patients more likely to be seen by multiple institutions were younger or had more severe disease at diagnosis.

Population-based data show that one in six newly diagnosed cancer patients received care from multiple institutions, and differed from patients seen only at a single institution. Cancer care data from single institutions may be incomplete and possibly biased.

Cancer epidemiology. 2016 Jan 02 [Epub ahead of print]

Christina A Clarke, Sally L Glaser, Rita Leung, Kathleen Davidson-Allen, Scarlett L Gomez, Theresa H M Keegan

Cancer Prevention Institute of California, Fremont, CA, United States; Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA, United States. Electronic address: ., Cancer Prevention Institute of California, Fremont, CA, United States; Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA, United States., Cancer Prevention Institute of California, Fremont, CA, United States., Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA, United States.

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