Quality of Breast, Colorectal Cancer Care to be Studied by State Health Department Researchers

Project Seeks to Identify Opportunities for Improving Care, Outcomes

ALBANY, N.Y. (Dec. 3, 2008) – Two researchers with the New York State Health Department and an oncologist with the Dana Farber Cancer Institute in Boston will examine the quality of breast and colorectal cancer care in New York State to identify opportunities for improving care.

Funded by a two-year $500,000 grant from the federal Centers for Disease Control and Prevention through the Association of Schools of Public Health, the research project will allow the most comprehensive examination of the quality of breast and colorectal cancer care to date by linking information from four major but separate data sources: the New York State Cancer Registry, the New York State Medicaid program, federal Medicare claims data, and the New York State Hospital Discharge-Ambulatory Surgery (SPARCS) data system.

"This project will provide our researchers with an unprecedented opportunity to comprehensively examine the quality of breast and colorectal cancer care in New York," said State Health Commissioner Richard F. Daines, M.D. "The additional information gleaned from linking these data sources is expected to be significant and will allow researchers to see how quality of care varies among different populations."

Two of the most common cancers, breast and colorectal cancer account for approximately 25,000 new cancer diagnoses in New York State each year. But many cancer patients do not receive optimal care. The lack of comprehensive data systems for measuring quality make it difficult to address shortfalls systematically, according to the National Cancer Policy Board of the Institute of Medicine. The Institute recommends that central cancer registries be linked to claims and hospital discharge files to produce state or national data on the quality of cancer care.

The researchers will evaluate breast and colorectal cancer care among New Yorkers using 23 quality of care measures that are considered best practices. For example, one quality measure is whether a patient received radiation following breast-conserving cancer surgery, such as a lumpectomy. The measures were developed by national organizations, including the American Society of Clinical Oncology and the American College of Surgeons.

Researchers will determine the number and percent of Medicaid and Medicare insured patients receiving care that meet the quality measures. The project will also examine racial/ethnic and socio-demographic disparities in quality of care and determine how quality of care varies by duration of Medicaid enrollment. Additionally, researchers will assess the costs and complications involved in obtaining, using and combining multiple data sources.

Records for breast and colorectal cancers diagnosed from 2004 through 2006 among adults age 18 and over will be extracted from the New York State Cancer Registry and linked to Medicaid, Medicare and SPARCS data. The New York State Cancer Registry collects, processes and reports information about every New Yorker diagnosed with cancer. The SPARCS system collects information on patient characteristics, diagnoses and treatments, services, and charges for hospitalized patients, ambulatory surgery patients, and emergency department admissions.

The cancer quality research team includes Maria J. Schymura, Ph.D., Director, and Francis P. Boscoe, Ph.D., research scientist, with the New York State Cancer Registry in the State Health Department; and Deborah Schrag, M.D., an oncologist from Dana Farber Cancer Institute and a faculty member at Harvard Medical School.