ArticleMedicine2019
Predictors of quality of care and survival in a three-state cohort of locally advanced cervical cancer patients and development of a predictive model to identify women at risk of incomplete treatment.
Article in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevention and management of radiotherapy-related toxicities in gynecological malignancies. Position paper on behalf of AIRO (Italian Association of Radiotherapy and Clinical Oncology).La Radiologia medica · 2024Guideline
- Improved survival in cervical cancer patients receiving care at National Cancer Institute-designated cancer centers.Cancer · 2022Article
- Treatment of cervical cancer: overcoming challenges in access to brachytherapy.Expert review of anticancer therapy · 2022Review
- To what extent do age, stage and treatment influence survival after invasive cervical cancer: a French population-based study.Cancer causes & control : CCC · 2022Article
- Effect of high-quality nursing on negative emotions and hope levels of patients undergoing oral and maxillofacial surgery.American journal of translational research · 2021Article
- Effect of high-quality nursing on negative psychological moods and quality of life of elderly patients with hypertension.American journal of translational research · 2021Article
- Development, implementation, and associated challenges of a new HDR brachytherapy program.BrachytherapyArticle
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Authors and funding
6 authors.
Funding
Abstract
To expand our prior statewide analysis of care distribution for locally advanced cervical cancer in Virginia to include 2 more states and to develop a tool for predicting quality of care. Complete treatment was defined as receiving chemotherapy (CT), brachytherapy (BT), and external beam radiotherapy.State cancer registry databases yielded a three-state cohort of 3197 women diagnosed with locally advanced cervical cancer from 2000 to 2013. A logistic regression evaluated predictors for receipt of BT, CT, and high (2-3 modalities received) versus low (0-1 modalities received) quality care. A Cox proportional hazards models determined predictors of survival. Finally, a predictive model was developed and preliminarily validated using our cohort.Only 35.3% of the cohort received complete treatment and only 57.3% received BT. Significant predictors of lower odds of receiving high quality care varied by state but included: 66+ age at diagnosis as compared to 18 to 42, 42 to 53, or 53 to 66; cancer stage IVA as compared to IIIx, IIx, or IB2; public insurance with supplement as compared to private; treatment at a low volume facility; and closer distance quintiles to a high volume treatment center as compared to the furthest quintile. Significant predictors of worse survival varied by state but included: low quality score (0-1 modalities received); 2000 to 2004 or 2005 to 2009 year of diagnosis as compared to 2010 to 2013; 66+ age at diagnosis as compared to 18 to 42, 42 to 53, or 53 to 66; cancer stage IVA as compared to IIIx, IIx, or IB2; treatment at a low volume facility; and unmarried/unknown marital status as compared to married. Our treatment quality prediction tool included age, age, treatment at high volume facility, and cancer stage and demonstrated 78.2% sensitivity and a 62.9% specificity.Only 35.3% of patients received complete guidelines-concordant treatment. Additionally, in 2/3 states it appeared that BT usage may have decreased during the study period. Our predictive model may help identify patients/regions at risk of receiving low quality care to target interventions aimed at improving cervical cancer treatment quality and survival.
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