Patricia Chapman

Abstract 3464: Low concordance with CEA tumor marker monitoring in colorectal cancer survivors

Purpose: To assess providers’ concordance with surveillance and risk reduction recommendations for colorectal cancer (CRC) survivors after completion of their curative treatment. Patients and Methods: This was a longitudinal study of survivors who met the following eligibility criteria: diagnosed with a primary colon or rectal cancer before their first visit (V) to the CRC Survivorship Clinic, adult survivor ≥ 18 years old, no evidence of disease, alive at the time of data abstraction, and 1-3 clinic visits between 9/01/2011 and 8/31/2014. Data were collected at V1 scheduled between 9/1/2011 and 8/31/2012. V2 was scheduled 9-15 months after the first visit. V3 was also scheduled 9-15 months after V2. Data sources were survivorship care plans, electronic medical records, and CRC survivorship algorithms. For an annual visit, CRC algorithms recommended history/physical exams (H & PEs), carcinoembryonic antigen (CEA) testing when previously elevated, and colonoscopies for surveillance of cancer recurrence. Concordance rates (CR) were measured as the percent of yes/no responses to whether the providers followed minimum standards for the 3 procedures. Demographic and clinical characteristics were also collected. Descriptive statistics were used to summarize all data. Results: 81 of 117 CRC survivors who met all eligibility criteria were included in this sub-analysis. The number of survivors visits varied across time, V1 = 81, V2 = 56, and V3 = 36. Most survivors were male (51.9%) and Caucasian (66.7%). 67.9% reported being 5-8 years post-treatment. 58% were diagnosed with colon cancer and of those 61.7% were Stage IIIA-IV compared to 55.8% of rectal cancer survivors with advanced disease. Table 1 summarizes the percentage of CR rates across the 3 visits. Conclusion: CRs for H & PEs and colonoscopies remained high across the 3 visits. CRs were lowest for CEA recommendations. These low rates suggest further work is needed to determine barriers in clinical practice that limit use of CEA tumor marker monitoring in CRC survivors. Citation Format: Guadalupe Palos, Katherine R. Gilmore, Patricia Chapman, Paula Lewis-Patterson, Weiqi Bi, Maria Alma Rodriguez. Low concordance with CEA tumor marker monitoring in colorectal cancer survivors. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3464.

Application of a standard practice-based system to measure and compare quality of cancer survivorship care.

239 Background: Despite the growing committment to improve survivorship care, measuring its quality remains difficult. In 2006, the American Society of Clinical Oncologists (ASCO) launched a practice-based system known as the Quality Oncology Practice Initiative (QOPI) to measure the quality of cancer care. Here, we demonstrate the use of QOPI procedures to compare compliance with survivorship care plans (SCPs) across different disease-specific clinics. METHODS Measures based on survivorship clinical practice guidelines were abstracted from SCPs issued to survivors scheduled for appointments in site-specific clinics. Following QOPI procedures, we identified the target condition as cancer, selected data collection methods, and determined core measures for abstraction. Procedures included; identifying the number of survivors arriving for appointments within the specified time period, standardizing denominators and numerators used per clinic, determining the number of full-time providers per clinic, and calculating the number of records to audit per clinic. All data were obtained from completed care plans, institutional electronic medical records, and scheduling systems. Descriptive statistics were used to conduct aggregate analyses of de-identified data. The same procedures were followed in each clinic. RESULTS From September 1, 2014, to August 31, 2015, we used a standard process to assess compliance for issuing survivorship care plans across 9 clinics. There were a total of 8864 arrived appointments; 46 providers completed a total of 7448 electronic survivorship care plans over the time period. Analysis of compliance rates indicated broad variation across clinics, including: breast (85.3%), gastrointestinal (80.2%), genitourinary (88.5%), gynecology (78.6%), head/neck (96.8%), lymphoma (99.3%), melanoma (62.2%), thyroid (75.4%) and thoracic (63.3%). CONCLUSIONS Establishing uniform procedures, such as the QOPI process, to measure and compare compliance with SCPs will help achieve high quality standards of care for long-term cancer survivors. Further examination is warranted to determine longitudinal trends and factors contributing to variation in compliance rates.