Low number of hospitals compliant with colon cancer examination guideline

More than 60% of hospitals studied were not compliant with the American Joint Committee on Cancer’s 12-node guideline when examining patients with colon cancer, according to recently published data.

The guidelines, which recommend the examination of 12 or more lymph nodes in patients with colon cancer, have been adopted by several oncology organizations, but information on compliance has not yet been available.

Researchers from the American College of Surgeons and the Northwestern University School of Medicine in Chicago analyzed data from 1,296 hospitals from the National Cancer Database to determine guideline compliance. They obtained data for 74,669 patients with colon cancer who had colectomy between 1996 and 1997 and 82,120 patients who had colectomy between 2004 and 2005. Compliance was defined as examination of 12 or more lymph nodes in 75% of patients or more.

After reviewing data for 2004 and 2005, the researchers reported an increase in hospital compliance since 1996 and 1997 (15% vs. 38%). From 1996 and 1997 to 2004 and 2005, 980 hospitals increased compliance frequency, six hospitals maintained frequency and 310 decreased frequency.

Comprehensive Cancer Centers as designated by the National Cancer Institute had the highest compliance rates; 78.1% of patients with colon cancer were examined for 12 or more lymph nodes between 2004 and 2005. Other academic institutions examined 52.4% of patients, Veterans’ Administration hospitals examined 53.1% and community hospitals examined 33.7% (P<.001).

Despite an increase in compliance in the last decade, “the majority of hospitals failed to comply with the 12-node measure,” the researchers wrote.

J Natl Cancer Inst. 2008;100:1310-1317.