Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “NCCN Guideline Concordance in Colon and Rectal Cancer Patients Within a Comprehensive Health System,” published in the November 2024 issue of Surgery by Robinson et al.     

The National Comprehensive Cancer Network (NCCN) provides evidence-based guidelines for colorectal cancer treatment. Guideline concordance is associated with improved outcomes for people with colorectal cancer. 

Researchers conducted a retrospective study to examine rates of guideline concordance and factors influencing non-concordant care in people with colon and rectal cancer. 

They identified people with colorectal cancer from a 16-hospital health system cancer registry (2011-2021). Major (MAJ) and minor (MIN) quality indicators of NCCN guideline-concordance were defined. Regression methods were used to identify predictors of MAJ non-concordance, and county-level mapping was used to identify geographic patterns. 

The results showed that 24.7% (573) of people had complete guideline concordance, 63.3% (1471) had MIN non-concordance, and 12.4% (280) had MAJ non-concordance. Predictors of MAJ non-concordance for colon cancer included cancer stage, a Charlson-Deyo Score greater than 1, delays in treatment greater than 60 days, and care across multiple hospitals. For rectal cancer, predictors included delays in treatment greater than 60 days and receiving care at more than one facility. Marion County had the highest rates of non-concordance for both colon and rectal cancer. 

They concluded that most people in the health system received guideline-concordant care, but 12% of people had MAJ non-concordance, with specific geographic areas identified for improvement. 

Source: americanjournalofsurgery.com/article/S0002-9610(24)00666-4/abstract