Despite the fact that removing and testing at least 12 nearby lymph nodes during colorectal cancer surgery improves accurate staging and survival, most US hospitals are not reaching that goal.
In a recent study of nearly 1,300 hospitals, only 38 percent tested at least 12 nodes in 75 percent of colorectal cancer surgeries performed in 2004 and 2005.
Testing improved from 1996-97 when only 15 percent of hospitals met the 12-node measure. However, during that time, compliance actually went down in 310 hospitals. 980 hospitals improved, and 6 did not change.
The type of hospital influenced compliance rates with the following percentages meeting the goal after scientists adjusted for differences in cancer patients treated:
- 78.1 percent of National Cancer Institute-designated Comprehensive Cancer Centers
- 52.4 percent of other academic hospitals
- 53.1 percent of Veterans Administration hospitals
- 33.7 percent of community hospitals.
Karl Y. Bilimoria and his surgical colleagues concluded,
This study provides a national report card of nearly 1300 hospitals showing that more than 60% of institutions failed to achieve a compliance benchmark for the 12-node measure. Considerable improvement is needed in colon cancer nodal evaluation in the United States.
SOURCE: Bilimoria et al, Journal of the National Cancer Institute, advance access published online September 9, 2008.
Another article about the study is available from Reuters.