September 9, 2008 / 8:08 PM / in 9 years

Hospitals fail colon cancer quality check

WASHINGTON (Reuters) - Most U.S. hospitals are failing to meet a key quality benchmark for care of colon cancer patients -- checking enough lymph nodes after surgery to see if the cancer has spread, researchers said on Tuesday.

Leading medical organizations say doctors should examine at least 12 lymph nodes to figure out whether colon cancer has metastasized -- spread to other parts of the body -- and to accurately diagnose the stage, or severity, of the cancer.

This information helps guide future treatment, including whether a patient with metastatic cancer gets the chemotherapy that can help improve survival.

But a review of data from 1,296 U.S. hospitals showed that only 38 percent of them checked at least 12 lymph nodes in at least three quarters of patients who had undergone surgery to remove colon cancer in 2004 and 2005.

This marks an increase over the 15 percent of hospitals that met this standard in 1996 and 1997, but was still far shy of what is recommended, the researchers wrote in the Journal of the National Cancer Institute.

“We were disappointed at how low the compliance rate is still,” said Dr. Karl Bilimoria of Northwestern University’s Feinberg School of Medicine in Chicago, who led the study.

Treatment for colon cancer involves surgery to remove the part of the colon that contains the cancer along with some healthy tissue on either side of the cancer to help ensure none remains behind. Nearby lymph nodes then are removed and tested for the presence of cancer.

Checking too few lymph nodes may give a false impression that cancer has not spread.

It is not uncommon to fail to find cancer if only six lymph nodes are checked -- only to detect it when more lymph nodes are examined, Bilimoria said.

The researchers are trying to figure out why so few hospitals are meeting the standard.

“Maybe some people don’t know that they should be reaching a certain number. And certainly there may be some people who don’t believe that it’s important,” Bilimoria said.

Information on 82,120 patients treated in 2004 and 2005 was included in the study. The hospitals that did not meet the standard treat about two thirds of colon cancer U.S. patients.

The study came out a day after other research also raised questions about the quality of U.S. colon cancer care.

A team led by Dr. Gregory Cooper of University Hospitals Case Medical Center in Cleveland found that 60 percent of older patients successfully treated for colon cancer were not given the recommended screening to detect any recurrence of cancer.

Editing by Alan Elsner and Julie Steenhuysen

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