Measuring the quality of care in metastatic colorectal cancer: a scoping review of quality indicators.

Abstract

Background: Quality indicators are essential for measuring and benchmarking the quality of cancer care. Although there are well-established metrics for early-stage colorectal cancer (CRC), few exist for advanced CRC. This scoping review aimed to collate and review all quality indicators for metastatic CRC.

Methods: A dedicated search was performed of Web of Science, PubMed, CINAHL, and relevant gray literature to identify quality indicators for metastatic CRC, evaluating the diagnostic workup, systemic anticancer treatments, surgical approaches, radiation approaches, supportive care, and palliative or terminal care provided to patients.

Results: We identified 11 articles, of which 5 were systematized reviews and 6 concerned the development, validation, or operationalization of quality indicators. Thirty-five distinct quality indicators for metastatic CRC were extracted across 6 domains of care: 1) diagnosis, staging, and treatment planning; 2) systemic anticancer treatment; 3) radiation oncology; 4) surgical approaches; 5) supportive care; and 6) palliative and end-of-life care, with a general quality indicator of overall survival. Of the 35 quality indicators extracted, 8 (23%) were unique to metastatic CRC and 27 (77%) were generic quality indicators across different tumor types but applicable to metastatic CRC.

Conclusion: There are few quality indicators specifically relevant to metastatic CRC. Those that do exist are generally generic process measures used across tumor types and do not measure the nuance or complexity of current multidisciplinary treatment of patients with metastatic CRC.