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Article

Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain

1
Radiation Oncology Department, University Hospital Virgen Macarena, 41009 Sevilla, Spain
2
Escuela Andaluza de Salud Pública, 18011 Granada, Spain
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Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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CIBER de Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Medical Sciences Department, Faculty of Medicine, University of Girona (UdG), 17071 Girona, Spain
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Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Department of Health, Government of Catalonia, 17007 Girona, Spain
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Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute—IDIBGI, Salt, 17190 Girona, Spain
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Medical Oncology Department, Catalan Institute of Oncology, University Hospital Dr Josep Trueta, 17007 Girona, Spain
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Department of Clinical Sciences, IDIBELL, University of Barcelona, Hospitalet, 08908 Barcelona, Spain
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Department of Health, Catalonian Cancer Strategy, Hospitalet, 08908 Barcelona, Spain
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Department of Preventive Medicine and Public Health, University of Granada, 18010 Granada, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6697; https://doi.org/10.3390/ijerph17186697
Received: 21 July 2020 / Revised: 6 September 2020 / Accepted: 9 September 2020 / Published: 14 September 2020
(This article belongs to the Special Issue Population Health and Health Services)
Colorectal cancer (CRC) is the third most common cancer worldwide. Population-based, high-resolution studies are essential for the continuous evaluation and updating of diagnosis and treatment standards. This study aimed to assess adherence to clinical practice guidelines and investigate its relationship with survival. We conducted a retrospective high-resolution population-based study of 1050 incident CRC cases from the cancer registries of Granada and Girona, with a 5-year follow-up. We recorded clinical, diagnostic, and treatment-related information and assessed adherence to nine quality indicators of the relevant CRC guidelines. Overall adherence (on at least 75% of the indicators) significantly reduced the excess risk of death (RER) = 0.35 [95% confidence interval (CI) 0.28–0.45]. Analysis of the separate indicators showed that patients for whom complementary imaging tests were requested had better survival, RER = 0.58 [95% CI 0.46–0.73], as did patients with stage III colon cancer who underwent adjuvant chemotherapy, RER = 0.33, [95% CI 0.16–0.70]. Adherence to clinical practice guidelines can reduce the excess risk of dying from CRC by 65% [95% CI 55–72%]. Ordering complementary imagining tests that improve staging and treatment choice for all CRC patients and adjuvant chemotherapy for stage III colon cancer patients could be especially important. In contrast, controlled delays in starting some treatments appear not to decrease survival. View Full-Text
Keywords: colorectal cancer; adherence; clinical practice guidelines; population-based study; high-resolution study; cancer survival colorectal cancer; adherence; clinical practice guidelines; population-based study; high-resolution study; cancer survival
MDPI and ACS Style

Carrasco-Peña, F.; Bayo-Lozano, E.; Rodríguez-Barranco, M.; Petrova, D.; Marcos-Gragera, R.; Carmona-Garcia, M.C.; Borras, J.M.; Sánchez, M.-J. Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain. Int. J. Environ. Res. Public Health 2020, 17, 6697. https://doi.org/10.3390/ijerph17186697

AMA Style

Carrasco-Peña F, Bayo-Lozano E, Rodríguez-Barranco M, Petrova D, Marcos-Gragera R, Carmona-Garcia MC, Borras JM, Sánchez M-J. Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain. International Journal of Environmental Research and Public Health. 2020; 17(18):6697. https://doi.org/10.3390/ijerph17186697

Chicago/Turabian Style

Carrasco-Peña, Francisco, Eloisa Bayo-Lozano, Miguel Rodríguez-Barranco, Dafina Petrova, Rafael Marcos-Gragera, Maria Carmen Carmona-Garcia, Josep Maria Borras, and Maria-José Sánchez. 2020. "Adherence to Clinical Practice Guidelines and Colorectal Cancer Survival: A Retrospective High-Resolution Population-Based Study in Spain" International Journal of Environmental Research and Public Health 17, no. 18: 6697. https://doi.org/10.3390/ijerph17186697

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