Study: Colon Cancer Patients in HMOs Receive Same Level of Care

Researchers at the University of Toronto who examined 50 studies found that characteristics of colon cancer patients and their physicians had the greatest influence on the type of treatment they received and survival rates.

Patients with colon cancer who are treated in HMOs seem to receive the same level of care and have similar survival rates to patients treated under traditional insurance plans, the researchers reported in the Journal of the National Cancer Institute.

The study also found that black and Native Americans received less intensive treatments and had worse outcomes than white patients, but survival times were the same for blacks and whites if they had the same treatments.

Men and women were both likely to receive chemotherapy but elderly patients were not as likely to receive the treatment as younger patients, said the researchers. This finding raises concern that older patients who might benefit from chemotherapy are not receiving it. This may be due, in part, to older patients being more vulnerable to the toxic side effects of drugs and may have other health problems that could prevent them from receiving chemotherapy treatment.

Patients were less likely to have a colostomy if their physician worked in a hospital with a high volume of colorectal cancer patients, according to the study. Researchers suggest that surgeons in these hospitals may have more technical expertise in handling difficult tumor removals and may be able to avoid performing a colostomy. The patients may also have better access to radiation and chemotherapy than at other hospitals.

Variations in treatment of patients with colon cancer may arise from inadequate physician knowledge of practice guidelines, treatment decisions based on unmeasured clinical factors, or patient preferences, according to the researchers.

"Understanding the causes of variations in clinical practice and outcomes will provide the basis for improving quality of care by applying the best available treatment to all eligible patients with colorectal cancer," said the study.

Other sources: Reuters