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Monitoring Breast Cancer Care Quality at National and Local Level Using the French National Cancer Cohort
Sophie Houzard1, Emilie Courtois1, Christine Le Bihan Benjamin1
1Survey Data Science and Assessment Division, National Cancer Institute, Boulogne Billancourt, France.
Clinical Breast Cancer
|June 24, 2022
Summary
French breast cancer care largely meets quality indicators, but significant regional variations exist. Analysis of these breast cancer (BC) quality indicators (QIs) is crucial for improving patient outcomes and reducing inequities.
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Breast cancer (BC) is the most common cancer, necessitating standardized quality of care.
- The French National Cancer Institute developed breast cancer-specific Care Quality and Safety Indicators (BC QIs) to address practice heterogeneity and regional inequities.
Purpose of the Study:
- To measure the adherence to available BC QIs using the French National medico-administrative cancer database (French Cancer Cohort) for the year 2018.
- To support local and national quality improvement initiatives for breast cancer care pathways and outcomes.
Main Methods:
- BC QIs were developed using the RAND method, based on clinical practice and care pathway recommendations.
- QI computation was automated using existing medico-administrative data, avoiding additional data collection workload.
- Ten feasible and pertinent BC QIs were selected for analysis.
Main Results:
- Overall compliance with most BC QIs was high, with notable rates for pre-treatment biopsy (94.5%) and post-lumpectomy radiotherapy (94.5%).
- Specific indicators showed lower adherence, such as immediate breast reconstruction for DCIS (54.3%) and reintervention for NMIBC (14.4%).
- Significant variations in QI adherence were observed across different regions and patient groups.
Conclusions:
- Breast cancer care in France generally aligns with quality standards, but areas for improvement remain.
- Local analysis of QI results is essential to identify specific leverage points for quality enhancement.
- Increased transparency regarding QI performance can empower the public and drive further improvements in breast cancer care.
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