ArticleAmerican journal of surgery2025
NCCN guideline concordance in colon and rectal cancer patients within a comprehensive health system.
Article in American journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Trajectory identification of high-risk subgroups after colorectal cancer surgery in patients with minimal residual disease: a single-center longitudinal study.Journal of gastrointestinal oncology · 2026Article
- Association of the Affordable Care Act With Receipt of Guideline-Concordant Adjuvant Chemotherapy for Colon and Non-Small Cell Lung Cancer.Cancer medicine · 2026Article
- Evaluating the prognostic significance of lymph node yield in resected pancreatic adenocarcinoma: a population-based study.World journal of surgical oncology · 2026Article
- Proteomic Analysis of Paired FFPE Tissue and Extracellular Vesicles Reveals Proteins Associated with Recurrence in Stage II Colorectal Cancer.Journal of proteome research · 2026Article
- Perineural invasion in solid tumors: biological foundations and the emerging integration of machine learning and artificial intelligence.Frontiers in oncology · 2026Review
- The patient journey and guideline-concordant care in colorectal cancer-is current practice enough?Frontiers in medicine · 2026Article
- Prognostic value of hemoglobin-to-red cell distribution width ratio and inflammation markers in colorectal cancer.World journal of gastrointestinal oncology · 2025Article
- [Postsurgical follow-up and long-term monitoring of colorectal cancer : Radiology as a key component].Radiologie (Heidelberg, Germany) · 2025Review
- Ongoing Failure to Deliver Guideline-Concordant Care for Patients with Pancreatic Cancer.Cancers · 2025Article
- Total neoadjuvant immunochemotherapy for proficient mismatch repair or microsatellite stable locally advanced rectal cancer.Frontiers in immunology · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundThe National Comprehensive Cancer Care Network (NCCN) provides recommendations for patients with colorectal cancer. Concordance with evidence-based guidelines improves outcomes. Our objectives were to 1) examine rates of guideline non-concordance in a large vertically integrated health system; 2) examine factors associated with non-concordant care, and 3) identify geographical patterns of non-concordant care.
methodsColorectal cancer patients were identified from a single-state 16 hospital health-system cancer registry diagnosed between 2011 and 2021. We defined major (MAJ) and minor (MIN) quality indicators of guideline-concordance based on NCCN guidelines. Regression methods were used to identify predictors of major quality criteria non-concordance. County-level mapping was used to identify geographical locations of the highest rates of non-concordance.
resultsOverall, 2324 patients with colon and rectal cancer were analyzed. There was a complete guideline concordance (an absence of guideline non-concordance) rate of 24.7% (n = 573), MIN only guideline non-concordance rate of 63.3% (n = 1471), and MAJ non-concordance rate of 12.4% (n = 280). Predictors of MAJ non-concordance for colon cancer were stage, >1 Charleson-Deyo Score, >60 days from diagnosis to treatment, and >1 hospital network used for care. Predictors of MAJ non-concordance for rectal cancer were >60 days from diagnosis to treatment, and >1 facility used for care. Marion county had the highest rates of non-concordance for colon and rectal cancer.
conclusionThe majority of colon and rectal cancer patients in a large health system received guideline concordant major quality indicators, however 12% of patients do not. An identifiable geographical location with the highest rates of non-concordance and its associated factors serves as a target for future quality improvement.
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