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. 2018 Jul 11;18(1):733.
doi: 10.1186/s12885-018-4604-2.

Quality indicators of clinical cancer care for prostate cancer: a population-based study in southern Switzerland

Laura Ortelli  1 , Alessandra Spitale  2 , Luca Mazzucchelli  3 , Andrea Bordoni  2
Affiliations

Quality indicators of clinical cancer care for prostate cancer: a population-based study in southern Switzerland

Laura Ortelli et al. BMC Cancer. .

Abstract

Background: Quality of cancer care (QoCC) has become an important item for providers, regulators and purchasers of care worldwide. Aim of this study is to present the results of some evidence-based quality indicators (QI) for prostate cancer (PC) at the population-based level and to compare the outcomes with data available in the literature.

Methods: The study included all PC diagnosed on a three years period analysis (01.01.2011-31.12.2013) in the population of Canton Ticino (Southern Switzerland) extracted from the Ticino Cancer Registry database. 13 QI, approved through the validated Delphi methodology, were calculated using the "available case" approach: 2 for diagnosis, 4 for pathology, 6 for treatment and 1 for outcome. The selection of the computed QI was based on the availability of medical documentation. QI are presented as proportion (%) with the corresponding 95% confidence interval.

Results: 700 PC were detected during the three-year period 2011-2013: 78.3% of them were diagnosed through a prostatic biopsy and for 72.5% 8 or more biopsy cores were taken. 46.5% of the low risk PC patients underwent active surveillance, while 69.2% of high risk PC underwent a radical treatment (radical prostatectomy, radiotherapy or brachytherapy) and 73.5% of patients with metastatic PC were treated with hormonal therapy. The overall 30-day postoperative mortality was 0.5%.

Conclusions: Results emerging from this study on the QoCC for PC in Canton Ticino are encouraging: the choice of treatment modalities seems to respect the international guidelines and our results are comparable to the scarce number of available international studies. Additional national and international standardisation of the QI and further QI population-based studies are needed in order to get a real picture of the PC diagnostic-therapeutic process progress through the definition of thresholds of minimal standard of care.

Keywords: Cancer registry; Population-based study; Prostate cancer; Quality indicators; Quality of cancer care.

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Conflict of interest statement

Ethics approval and consent to participate

Data collection on cancer cases is authorized and regulated by the following cantonal law and the concerning regulation:

  1. Legge sul registro dei tumori del 21 giugno 1994: https://m3.ti.ch/CAN/RLeggi/public/index.php/raccolta-leggi/legge/vid/18b;

  2. Regolamento della Legge sul Registro dei tumori del 9 giugno 1998: https://m3.ti.ch/CAN/RLeggi/public/index.php/raccolta-leggi/legge/vid/06_31.

According to the above mentioned law and regulation, the present study needs no formal ethics approval and the informed consent to participate is not necessary.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
QI6. Completeness of pathology reports for prostatectomy specimens: comparison between southern-Switzerland and U.S
Fig. 2
Fig. 2
QI7. Proportion of patients with low-risk prostate-cancer undergoing active-surveillance: comparison between southern-Switzerland and other countries
Fig. 3
Fig. 3
QI 8. Proportion of patients with high-risk prostate-cancer undergoing radical treatment: comparisons between southern-Switzerland and other countries
Fig. 4
Fig. 4
QI10. Proportion of patients with pT2 prostate-cancer with free-margins after radical-prostatectomy: comparison between southern-Switzerland and other countries
Fig. 5
Fig. 5
QI12. Proportion of patients with metastatic prostate-cancer (M1) treated with hormonal-therapy: comparison between southern-Switzerland and other countries
Fig. 6
Fig. 6
QI13. Proportion of patients with prostate-cancer died within 30-days from radical-prostatectomy: comparison between southern-Switzerland and other countries
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