Implementation of Quality Improvement Interventions in Medical Oncology: A Systematic Review.

Purpose: As global cancer rates rise, the demand for effective, high-quality delivery of systemic anticancer therapy (SACT) is crucial. However, quality improvement (QI) research in medical oncology remains limited. This systematic review aims to identify and characterize QI interventions addressing quality deficits in medical oncology practice, focusing on intervention types, methodologies, and outcomes.

Surgery or radiotherapy for early-stage cancer study (SORT) target trial protocol: stereotactic ablative radiotherapy (SABR) with curative intent versus surgical resection for early-stage non-small cell lung cancer (NSCLC).

Introduction: Randomised controlled trials have aimed to assess the effectiveness of stereotactic ablative radiotherapy (SABR) with curative intent versus surgical resection for individuals diagnosed with early-stage non-small cell lung cancer (NSCLC) but have failed to recruit sufficient numbers of patients. Non-randomised studies for early-stage NSCLC have reported mixed outcomes following curative SABR versus surgical resection, but did not fully address confounding by indication. The Surgery Or RadioTherapy for early-stage cancer study (SORT) will assess the comparative effectiveness of SABR with curative intent versus surgical resection for NSCLC with a target trial emulation approach, as this can reduce biases in observational studies that aim to estimate the causal effect of interventions.

The effect of centralising novel cell therapies for solid cancers - a health systems planning model for Europe.

Background: Integrating cell therapies for solid cancers requires centralising services to ensure high quality and poses unique challenges for all healthcare systems. In this national population-based study, we modelled the effect of different centralisation scenarios in the English NHS on travel times, equity and hospital capacity as an archetype to inform European planning.

Methods: We identified 10,050 patients treated with systemic therapy for metastatic colorectal cancer in 139 NHS hospitals between 2016 and 2018.

The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach.

Background: Palliative care aims to maintain quality of life and offer treatment and person-centred care options for people with serious end-stage illnesses and their families. The purpose of this exploratory study was to compare the statutory coverage and access to palliative care for adult services for people with cancer in 8 European countries using a vignette approach.

Methods: We used a patient vignette to examine coverage and access to palliative care services across Europe.

Quality indicators and patient outcome measures for palliative care in cancer patients: a systematic review.

Introduction: With the exponential rise in global cancer incidence, the surge in demand for palliative care has outstripped capacity, limiting patients' access to quality and holistic palliative care, especially in low- and middle-income countries. Despite an upturn in research activity, evidence in palliative care remains limited, given its complexity as well as the shortage of standardised quality indicators (QIs) and patient outcome measures (POMs). The objective of this systematic review is to assess the QIs and POMs used to evaluate palliative care service on aggregated and individual levels.

Delayed Primary Hip Arthroplasty for Geriatric Low-Energy Femoral Neck Fracture Is Not Associated With Worse Outcomes: A Study of the Arthroplasty for Hip Fracture Consortium.

Background: There is no consensus on the association between mortality and surgical delay in hemiarthroplasty (HA) or total hip arthroplasty (THA) for elderly, low-energy, displaced femoral neck fractures (FNFs). This study assessed whether delayed surgery is associated with worse outcomes.

Methods: This retrospective study reviewed FNF in patients > 60 years among nine academic tertiary-care institutions from January 2010 through December 2019.

Characteristics of interventions aimed at reducing inequalities along the cancer continuum: A scoping review.

Cancer inequalities are wide and enduring, within countries between socio-demographic groups and between countries. These are generated and sustained throughout the key phases of the cancer pathway, from investigation, clinical assessment, decision and access to treatment, and follow-up care. We aimed to describe the characteristics of implemented interventions, evaluated in published controlled experiments in the medical literature, specifically designed to target reductions in inequalities along the cancer pathway.

Navigating Scientific Progress in Radiation Oncology: Comprehensive Analysis of Clinical Trials From the Past Two Decades Using the ClinicalTrials.gov Database.

Purpose: Oncology has experienced substantial growth in clinical trial activity over the past two decades, but a comprehensive evaluation of radiation oncology research is lacking. This study analyzed trends in radiation therapy trials using data from ClinicalTrials.gov.

The National Cancer Audit Collaborating Centre (NATCAN): improving the quality of National Health Service cancer care in England and Wales.

The National Cancer Audit Collaborating Centre (NATCAN) was launched on Oct 1, 2022, and is delivering ten national cancer audits to assess and assure the quality of National Health Service (NHS) cancer care in England and Wales. These audits are a collaboration between clinical leaders, methodological experts, professional organisations, civil society, and policy makers to develop and implement performance measures across all NHS cancer care and inform quality improvement of the care pathway. The aims of NATCAN are to provide transparent and timely feedback to hospitals about their practices and outcomes of cancer care, identify opportunities for improvement of cancer care, and support hospitals to conduct quality-improvement initiatives.

Geographic, socioeconomic and demographic inequalities in the incidence of metastatic prostate cancer at time of diagnosis in England: a population-based evaluation.

Objective: To evaluate the area-based incidence of metastatic prostate cancer at diagnosis, reflecting the risk of late-stage diagnosis, and overall prostate cancer incidence, reflecting the risk of over-diagnosis, in a country without a formal screening programme.

Methods And Analysis: National study of annual prostate cancer incidence between 2015 and 2019. Mixed-effects regression estimated area-based incidence, adjusted for age, ethnicity and socioeconomic deprivation.

External validation of an algorithm to detect vertebral level mislabeling and autocontouring errors.

Background And Purpose: This work performs external validation of a previously developed vertebral body autocontouring tool and investigates a post-processing method to increase performance to clinically acceptable levels.

Materials And Methods: Vertebral bodies within CT scans from two separate institutions (40 from institution A and 41 from institution B) were automatically 1) localized and enumerated, 2) contoured, and 3) screened as a means of quality assurance (QA) for errors. Identification rate, contour acceptability rate, and QA accuracy were calculated to assess the tool's performance.

Are evidence-based guidelines translating into clinical practice? A national population-based study of the use of treatment intensification in metastatic hormone-sensitive prostate cancer (mHSPC) in England.

Background And Objective: International guidelines recommend treatment intensification combining docetaxel or androgen receptor pathway inhibitors with androgen deprivation therapy for metastatic hormone-sensitive prostate cancer (mHSPC). However, evidence suggests underuse in many high-income countries. This study evaluates the use of treatment intensification in the English National Health Service (NHS) and explores patient and hospital-level factors associated with variation.

Value of hospital administrative data linked to national cancer registry records to identify metastatic disease at time of primary diagnosis in colorectal cancer patients: a study using national data in England.

Background: Routinely collected data are increasingly being used for cancer research and health service evaluation. For both purposes, accurately identifying metastatic disease at diagnosis is essential. We developed an approach to identify metastatic disease at time of primary diagnosis according to national hospital administrative data (HAD) in patients identified with colorectal cancer (CRC) in the English national cancer registry (CR).

Improving performance in radiation oncology: An international systematic review of quality improvement interventions.

National cancer audits and registers have highlighted significant national and international variation in patient care and outcomes. Quality Improvement (QI) is mandated in radiation oncology but the interventions designed to support QI in this field remain poorly understood. This paper seeks to assess the types of QI interventions in radiation oncology, the QI evaluation design and their impact on process of care measures and patient-related outcomes.

Defining national research priorities for prostate cancer in Zambia: using the Delphi process for comprehensive cancer policy setting in sub-Saharan Africa.

Objectives: Locally led research on cancer is needed in sub-Saharan Africa to set feasible research priorities that inform national policy. The aim of this project was to develop a research agenda for national cancer control planning, using a nationally driven approach, focused on barriers to diagnosis and high-quality treatment for prostate cancer in Zambia.

Methods And Analysis: This was a Delphi process.

Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review.

The role of artificial intelligence (AI) in cancer care has evolved in the face of ageing population, workforce shortages and technological advancement. Despite recent uptake in AI research and adoption, the extent to which it improves quality, efficiency and equity of care beyond cancer diagnostics is uncertain to date. Henceforth, the objective of our systematic review is to assess the clinical readiness and deployability of AI through evaluation of prospective studies of AI in cancer care following diagnosis.

Global linear accelerator requirements and personalised country recommendations: a cross-sectional, population-based study.

Background: The Linear Accelerator Shortage Index (LSI) is a practical tool for prioritising the deployment of linear accelerators (LINACs) in various regions within a country. The LSI reflects the ratio of LINAC demand to current availability. The aim of this study was to use the LSI to predict global LINAC needs and classify countries according to the degree of radiotherapy shortage (LINAC shortage grade).

Preferences for speed of access versus certainty of the survival benefit of new cancer drugs: a discrete choice experiment.

Background: The extent to which patients with cancer are willing to accept uncertainty about the clinical benefit of new cancer drugs in exchange for faster access is not known. This study aims to examine preferences for access versus certainty, and to understand factors that influence these preferences.

Methods: A US nationally representative sample of older adults were recruited via Cint, an online platform for survey research, to take part in an online discrete choice experiment.

Is Centralisation of Cancer Services Associated With Under-Treatment of Patients With High-Risk Prostate Cancer?-A National Population-Based Study.

Background: Centralising prostate cancer surgical and radiotherapy services, requires some patients to travel longer to access treatment, but its impact on actual treatment utilisation and outcomes is unknown.

Methods: Using national cancer registry records linked to administrative hospital data, we identified all patients with high risk and locally advanced prostate cancer diagnosed between 1 April 2019 and 31 March 2020 in the English National Health Service (n = 15,971). Estimated travel times from the patient residential areas to the nearest hospital providing surgery or radiotherapy were estimated for journeys by car and by public transport.

Improving cancer outcomes through enhanced leadership and strategy training for cancer healthcare professionals - A course developed by the European School of Oncology (ESO), the European Cancer Organization (ECO) and Sharing Progress in Cancer Care (SPCC).

Leadership as a key building block of a health system plays a crucial role in achieving high performance and helps deliver change and shape the policy agenda and its implementation. Echoing the emerging need for effective leaders in Oncology, the "Improving Cancer Outcomes and Leadership Course" was developed jointly by the European School of Oncology (ESO), the European Cancer Organization (ECO) and Sharing Progress in Cancer Care (SPCC). The course was offered as a hybrid event online and in Warsaw in June 2022.