ArticleBMC cancer2014
Regional variation in breast cancer treatment in the Netherlands and the role of external peer review: a cohort study comprising 63,516 women.
Article in BMC cancer, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Impact of a peer-review network on the quality of inpatient low secure mental health services: cluster randomised control trial.BMC health services research · 2018Trial
- Treatment and survival ofESMO real world data and digital oncology · 2026Article
- Interhospital variations in diagnostic work-up following recall at biennial screening mammography-a population-based study.European radiology · 2025Article
- Effect of the COVID-19 Pandemic on Surgical Breast Cancer Care in the Netherlands: A Multicenter Retrospective Cohort Study.Clinical breast cancer · 2020Article
- Multidisciplinary care of breast cancer patients: a scoping review of multidisciplinary styles, processes, and outcomes.Current oncology (Toronto, Ont.) · 2019Article
- Two decades of external peer review of cancer care in general hospitals; the Dutch experience.Cancer medicine · 2016Article
- Evaluation of the utilization of external radiotherapy in the treatment of localized prostate cancer in Andalusia, Spain.Radiation oncology (London, England) · 2015Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment variation is an important issue in health care provision. An external peer review programme for multidisciplinary cancer care was introduced in 1994 in the Netherlands to improve the multidisciplinary organisation of cancer care in hospitals.So far the clinical impact of external quality assessment programmes such as external peer review and accreditation remains unclear. Our objective was to examine the degree of variation in treatment patterns and the possible effect of external peer review for multidisciplinary cancer care for breast cancer patients.
methodsPatients with breast cancer were included from 23 hospitals from two 'intervention regions' with the longest experience with the programme and 7 hospitals that never participated (control group). Data on tumour and treatment characteristics were retrieved from the Netherlands Cancer Registry. Treatment modalities investigated were: the completeness of breast conserving therapy, introduction of the sentinel node biopsy, radiotherapy after breast conserving surgery for ductal carcinoma in situ (DCIS), adjuvant radiotherapy for locally advanced breast cancer (T3/M0 or any T,N2-3/M0), adjuvant chemotherapy for early stage breast cancer (T1-2/N+/M0) and neo-adjuvant chemotherapy for T4/M0 breast cancer. Hospitals from the two intervention regions were dichotomised based on their implementation proportion (IP) of recommendations from the final reports of each peer review (high IP vs. low IP). This was regarded as a measure of how well a hospital participated in the programme.
results63,516 female breast cancer patients were included (1990-2010). Variation in treatment patterns was observed between the intervention regions and control group. Multidisciplinary treatment patterns were not consistently better for patients from hospitals with a high IP.
conclusionsThere is no relationship between the external peer review programme for multidisciplinary cancer care and multidisciplinary treatment patterns for breast cancer patients. Regional factors seem to exert a stronger effect on treatment patterns than hospital participation in external peer review.
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