Cancer is the main cause of death in the Netherlands and the number of people diagnosed with cancer continues to rise. We analyse the quality of oncological care and variation between institutions and across regions, with the ultimate aim of saving lives and improving the quality of life of patients with cancer.
Survival of individuals with cancer has been increasing in the last decades. However, our research has shown that there is room for further improvement in terms of diagnostics, treatment and follow-up. There are large institutional and regional variations with respect to quality of care, especially in terms of adequate diagnosis and referral for curative treatment. Working in close collaboration, the Department of Public Health, Erasmus MC and the Netherlands Comprehensive Cancer Organisation (IKNL) investigated the impact on treatment and survival of important developments in oncology, ranging from centralisation of care and measurement of quality indicators, and the introduction of new, often expensive medications. There is a special focus on quality of care in children and cost-effectiveness of treatment and follow-up of patients with skin cancer. Furthermore, based on reliable data, existing variations in treatment and outcome between hospitals have been calculated, made transparent, and discussed within the Comprehensive Cancer Network (CCN) Southwest Netherlands (EMBRAZE, a cooperation of Erasmus MC and hospitals in the provinces of Zeeland and Noord-Brabant). Quality of oncological care in CCN Southwest is being evaluated and monitored making use of data from the Netherlands Cancer Registry, data which are discussed at regional cancer specific meetings with medical professionals.
One of our PhD theses was featured in the NOS news.1 This thesis revealed that survival of patients with oesophageal cancer has almost doubled in the last 10 years, also thanks to centralisation of surgical care. However, patients with gastric or oesophageal cancer are still being diagnosed in every hospital in the Netherlands. Probably due to the lack of disease-specific knowledge and expertise in hospitals where curative treatment of gastric or oesophageal cancer is (no longer) given, patients are often not referred to a centre of excellence for further diagnostics or a curative treatment. Inadequate referral decreases the chance of survival of hundreds of patients each year. More intense cooperation at a regional level, for example by means of regional multidisciplinary team meetings, is warranted.
- Progress against childhood cancer in the Netherlands. A KiKa financed study in which progress against childhood cancer is evaluated, thereby also identifying room for improvement
- Reducing skin cancer costs. By studying (cost)effectiveness of treatment and follow-up of (non-melanoma) skin cancer, clinicians and policymakers can make better informed decisions, enabling reduction in costs and increased quality of care
- Reducing variation in treatment and outcome of cancer. Despite increased survival rates there is still room for improvement in cancer management. Thanks to centralisation of highly complex and low volume surgery, treatment and outcome have improved. However, patients are still diagnosed in all types of hospitals. Attention is needed for optimal diagnostics and referral to centres of excellence.