Related Experiment Videos
A Population-Based Evaluation of Quality Indicators for Uterine Cancer Care in Queensland, 2013-2022
Danny R Youlden1, Helen Hunt1, Karen Sanday1
1Cancer Alliance Queensland, Metro South Health, Brisbane, Queensland, Australia.
Aim:
To evaluate how diagnostic procedures, treatments, access, and outcomes for uterine cancer have evolved over the last decade using real-world data.
Methods:
A retrospective cohort study was conducted. Unit record data were sourced from the population-based Queensland Oncology Repository. Eighteen quality indicators were investigated. Patients with uterine cancer were stratified into two groups according to year of diagnosis (2013-2017 and 2018-2022). Poisson regression and multivariable flexible parametric survival modeling were used to evaluate changes over time, adjusted for key demographic and clinical characteristics.
Results:
The study cohort consisted of 5423 patients. Sentinel lymph node biopsy among patients who had a definitive resection increased dramatically from 14% to 61% (relative likelihood [RL] = 4.24, 95% CI 3.76-4.79; p < 0.001). Use of laparoscopic procedures also increased significantly for both Stages I/II (RL = 1.12, 95% CI 1.08-1.15; p < 0.001) and Stages III/IV (RL = 1.48, 95% CI 1.30-1.68; p < 0.001). The percentage of uterine cancer patients who received a definitive resection within 30 days of diagnosis fell from 56% to 51% (RL = 0.92, 95% CI 0.88-0.97; p = 0.001), with Aboriginal and Torres Strait Islander women faring worse (29%). There was no significant difference in the likelihood of dying within five years of definitive resection by period of diagnosis (adjusted hazard ratio = 0.87, 95% CI 0.74-1.03; p = 0.11).
Conclusion:
Our results have the dual purpose of highlighting opportunities for improvement while also providing benchmarks for the evaluation of uterine cancer care in Queensland into the future.
