Analysing the attributes of Comprehensive Cancer Centres and Cancer Centres across Europe to identify key hallmarks

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Abstract

There is a persistent variation in cancer outcomes among and within European countries suggesting (among other causes) inequalities in access to or delivery of high‐quality cancer care. European policy (EU Cancer Mission and Europe’s Beating Cancer Plan) is currently moving towards a mission‐oriented approach addressing these inequalities. In this study, we used the quantitative and qualitative data of the Organisation of European Cancer Institutes’ Accreditation and Designation Programme, relating to 40 large European cancer centres, to describe their current compliance with quality standards, to identify the hallmarks common to all centres and to show the distinctive features of Comprehensive Cancer Centres. All Comprehensive Cancer Centres and Cancer Centres accredited by the Organisation of European Cancer Institutes show good compliance with quality standards related to care, multidisciplinarity and patient centredness. However, Comprehensive Cancer Centres on average showed significantly better scores on indicators related to the volume, quality and integration of translational research, such as high‐impact publications, clinical trial activity (especially in phase I and phase IIa trials) and filing more patents as early indicators of innovation. However, irrespective of their size, centres show significant variability regarding effective governance when functioning as entities within larger hospitals.

Abstract

This study reveals the attributes of cancer centres based on data from 40 large European cancer centres, showing that Comprehensive Cancer Centres have significantly greater output of peer‐reviewed publications and clinical trials than other centres, and that the quality of multidisciplinarity is well established in all accredited cancer centres.

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Most cited references 28

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Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018

J Ferlay, M Colombet, I Soerjomataram … (2018)

Europe contains 9% of the world population but has a 25% share of the global cancer burden. Up-to-date cancer statistics in Europe are key to cancer planning. Cancer incidence and mortality estimates for 25 major cancers are presented for the 40 countries in the four United Nations-defined areas of Europe and for Europe and the European Union (EU-28) for 2018.

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Impact of hospital volume on operative mortality for major cancer surgery.

C Begg, L Cramer, W J Hoskins … (1998)

Hospitals that treat a relatively high volume of patients for selected surgical oncology procedures report lower surgical in-hospital mortality rates than hospitals with a low volume of the procedures, but the reports do not take into account length of stay or adjust for case mix. To determine whether hospital volume was inversely associated with 30-day operative mortality, after adjusting for case mix. Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database in which the hypothesis was prospectively specified. Surgeons determined in advance the surgical oncology procedures for which the experience of treating a larger volume of patients was most likely to lead to the knowledge or technical expertise that might offset surgical fatalities. All 5013 patients in the SEER registry aged 65 years or older at cancer diagnosis who underwent pancreatectomy, esophagectomy, pneumonectomy, liver resection, or pelvic exenteration, using incident cancers of the pancreas, esophagus, lung, colon, and rectum, and various genitourinary cancers diagnosed between 1984 and 1993. Thirty-day mortality in relation to procedure volume, adjusted for comorbidity, patient age, and cancer stage. Higher volume was linked with lower mortality for pancreatectomy (P=.004), esophagectomy (P<.001), liver resection (P=.04), and pelvic exenteration (P=.04), but not for pneumonectomy (P=.32). The most striking results were for esophagectomy, for which the operative mortality rose to 17.3% in low-volume hospitals, compared with 3.4% in high-volume hospitals, and for pancreatectomy, for which the corresponding rates were 12.9% vs 5.8%. Adjustments for case mix and other patient factors did not change the finding that low volume was strongly associated with excess mortality. These data support the hypothesis that when complex surgical oncologic procedures are provided by surgical teams in hospitals with specialty expertise, mortality rates are lower.

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The Role of Clinical Trial Participation in Cancer Research: Barriers, Evidence, and Strategies

Joseph M Unger, Elise D Cook, Eric Tai … (2016)

Fewer than one in 20 adult patients with cancer enroll in cancer clinical trials. Although barriers to trial participation have been the subject of frequent study, the rate of trial participation has not changed substantially over time. Barriers to trial participation are structural, clinical, and attitudinal, and they differ according to demographic and socioeconomic factors. In this article, we characterize the nature of cancer clinical trial barriers, and we consider global and local strategies for reducing barriers. We also consider the specific case of adolescents with cancer and show that the low rate of trial enrollment in this age group strongly correlates with limited improvements in cancer population outcomes compared with other age groups. Our analysis suggests that a clinical trial system that enrolls patients at a higher rate produces treatment advances at a faster rate and corresponding improvements in cancer population outcomes. Viewed in this light, the issue of clinical trial enrollment is foundational, lying at the heart of the cancer clinical trial endeavor. Fewer barriers to trial participation would enable trials to be completed more quickly and would improve the generalizability of trial results. Moreover, increased accrual to trials is important for patients, because trials provide patients the opportunity to receive the newest treatments. In an era of increasing emphasis on a treatment decision-making process that incorporates the patient perspective, the opportunity for patients to choose trial participation for their care is vital.

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Author and article information

Contributors

Simon Oberst:

ORCID: https://orcid.org/0000-0002-1139-2578

simon.oberst@cruk.cam.ac.uk

Journal

Journal ID (nlm-ta): Mol Oncol

Journal ID (iso-abbrev): Mol Oncol

Journal ID (doi): 10.1002/(ISSN)1878-0261

Journal ID (publisher-id): MOL2

Title: Molecular Oncology

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 1574-7891

ISSN (Electronic): 1878-0261

Publication date (Electronic): 30 March 2021

Publication date (Print): May 2021

Volume: 15

Issue: 5 ( doiID: 10.1002/mol2.v15.5 )

Pages: 1277-1288

Affiliations

[ ¹ ] Cancer Research UK Cambridge Institute University of Cambridge Li Ka Shing Centre UK

[ ² ] Organisation of European Cancer Institutes Brussels Belgium

[ ³ ] Cancer Research UK Cambridge Centre University of Cambridge UK

[ ⁴ ] the Netherlands Comprehensive Cancer Organisation (IKNL) Utrecht The Netherlands

[ ⁵ ] Rijnstate Hospital Arnhem The Netherlands

[ ⁶ ] Institut Jules Bordet Université Libre de Bruxelles Brussels Belgium

[ ⁷ ] National Institute of Oncology Budapest Hungary

[ ⁸ ] Division of Cancer Medicine Oslo University Hospital Oslo Norway

[ ⁹ ] Theme Cancer Karolinska University Hospital Stockholm Sweden

[ ¹⁰ ] Alliance Against Cancer Rome Italy

[ ¹¹ ] Institut Curie Paris Cedex 05 France

[ ¹² ] Radiotherapeutisch Instituut Friesland Leeuwarden The Netherlands

[ ¹³ ] Institut Gustave Roussy Villejuif France

[ ¹⁴ ] American Hospital of Paris Neuilly‐sur‐Seine France

[ ¹⁵ ] Masaryk Memorial Cancer Institute Brno Czech Republic

[ ¹⁶ ] Centre Léon Bérard Lyon France

[ ¹⁷ ] Ospedale Policlinico San Martino Genova Italy

[ ¹⁸ ] Cancer Intelligence Bristol UK

[ ¹⁹ ] The Netherlands Cancer Institute Amsterdam The Netherlands

[ ²⁰ ] Department of Health Technology and Services Research University of Twente Enschede The Netherlands

Author notes

[*] [* ] Correspondence

S. Oberst, Organisation of European Cancer Institutes, Rue d’Egmont, 11, 1000 Brussels, Belgium.

Email: simon.oberst@ 123456cruk.cam.ac.uk

Author information

Simon Oberst https://orcid.org/0000-0002-1139-2578

Article

Publisher ID: MOL212950

DOI: 10.1002/1878-0261.12950

PMC ID: 8096787

PubMed ID: 33734563

SO-VID: c95d0779-35a2-4660-b8d9-070df09b9be7

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

History

Date revision received : 06 March 2021

Date received : 05 January 2021

Date accepted : 17 March 2021

Page count

Figures: 5, Tables: 0, Pages: 12, Words: 7276

Funding

Funded by: Intuitive Surgical , open-funder-registry 10.13039/100010477;

Award ID: N/A

Funded by: Agendia BV

Award ID: N/A

Funded by: Organisation of European Cancer Institutes

Award ID: N/A

Funded by: Novartis , open-funder-registry 10.13039/100004336;

Award ID: N/A

Funded by: Hungarian Thematic Excellence Programme

Award ID: (TKP2020‐NKA‐26)

Custom metadata

source-schema-version-number 2.0

cover-date May 2021

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.2 mode:remove_FC converted:04.05.2021

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: accreditation,clinical trials,comprehensive cancer center,multidisciplinarity,quality standard,translational research

Data availability:

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: accreditation, clinical trials, comprehensive cancer center, multidisciplinarity, quality standard, translational research

Analysing the attributes of Comprehensive Cancer Centres and Cancer Centres across Europe to identify key hallmarks

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Karger: Oncology

Most cited references 28

Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018

Impact of hospital volume on operative mortality for major cancer surgery.

The Role of Clinical Trial Participation in Cancer Research: Barriers, Evidence, and Strategies

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