Assessing the Quality of Cancer Care An Approach to Measurement in Georgia (2005) / Chapter Skim
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3 Preventing Cancer
3 Preventing Cancer
Pages 54-78
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From page 54... ...
could harness much of the untapped potential of cancer prevention by working to close the gap between what is known and what is practiced in the common, everyday routines of physicians' offices. Among the first steps GCC might take to prevent unnecessary cancer morbidity and mortality are encouraging the use of evidence-based, effective means to help smokers quit smoking, as well as seeking to ensure that effective cancer screening procedures are used as recommended (see Chapter 4, Detecting Cancer Early)
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From page 55... ...
Cancer incidence rates are the ultimate indicators of the success of prevention efforts. With sustained meaningful improvement in cancer prevention, Georgia should eventually experience declining cancer incidence rates.
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From page 56... ...
The other two are measures to monitor delivery of recommended smoking cessation interventions: · Measure 3-3 -- Smokers who receive advice to quit -- the proportion of adult smokers who were advised to quit smoking during a visit with a doctor, nurse, or other health professional. · Measure 3-4 -- Smokers who are recommended pharmacotherapy to assist in quitting smoking -- the proportion of adult smokers whose doctor, nurse, or other health professional recommended or discussed medication to assist quitting smoking.
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From page 57... ...
, and pharmacotherapy delivered in primary care settings, are effective in helping adult smokers quit smoking and remain smoking-free after 1 year (USPSTF, 2002)
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. Tracking smoking rates and the delivery of smoking cessation interventions will help GCC monitor its impact on the leading preventable cause of cancer.
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. In its 2003 review of the evidence, the USPSTF found that the most effective interventions combine nutrition education and diet and exercise counseling with behavioral strategies to increase physical activity and help change eating habits.
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· Measure 3-7 -- Breast cancer incidence rate · Measure 3-8 -- Colorectal cancer incidence rate · Measure 3-9 -- Lung cancer incidence rate · Measure 3-10 -- Prostate cancer incidence rate Cancer incidence rates are important measures of the burden of cancer in a population, usually expressed as the number of newly diagnosed cancers
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From page 61... ...
Similarly, if Georgia markedly improves the quality and prevalence of colorectal cancer screening, this will ultimately be apparent in a corresponding decline in the incidence of colorectal cancer. Some caution is required in interpreting incidence rates since, in the short term, incidence may appear to increase in underscreened populations or with the introduction of more sensitive screening techniques.
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From page 62... ...
A considerable body of research has shown, for example, that smoking cessation interventions such as brief, behavioral counseling and pharmacotherapy are effective in helping adult smokers quit and remain smoking-free for 1 year. In this chapter, the IOM committee has recommended 10 quality-of-cancer-care measures to gauge GCC's success in closing the gap between what is known about cancer prevention and what is practiced in the common, everyday routines of Georgia's physician offices.
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From page 63... ...
blank Cancer and A data Registry; Healthy People 2010 of of National Surveillance Cancer required. are Quality Potential Benchmarking BRFSS descriptions Behavioral the for of B Risk collection Comprehensive and data A =Youth Georgia Measures = current Georgia Youth Tobacco Survey YRBSS to Appendixes GCCR and Report; GCCR and Georgia SEER System; Georgia-Based enhancements Recommended Sources, Quality Sources that for Data Potential Data Georgia BRFSS Surveillance and Healthcare indicates Sources Factor Methods, Data quit Risk smoking National symbol to = quit The rate measure.
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From page 64... ...
Colorectal Cancer Incidence Rate Measure 3-9. Lung Cancer Incidence Rate Measure 3-10.
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From page 65... ...
Approach to calculating the measure Numerator Number of adults who smoke cigarettes Denominator Number of adults Potential data source(s) Behavioral Risk Factor Surveillance System Comments Adjusted to year 2000 population standard.
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Approach to calculating the measure Numerator Number of students in grades 9 through 12 who smoked cigarettes on one or more of the previous 30 days Denominator Number of students in grades 9 through 12 Potential data source(s) Youth Risk Behavior Surveillance System; Youth Tobacco Survey Comments - Limitations Data only reflect the subset of adolescents enrolled in high school; thus, adolescents at greatest risk are missed (i.e.
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From page 67... ...
Approach to calculating the measure Numerator Number of adult smokers who were advised to quit smoking during a visit with a doctor, nurse, or other health professional in the past year Denominator Adults who smoke and who saw a doctor, nurse, or other health professional in the past year Potential data source(s) Behavioral Risk Factor Surveillance System Comments - Limitations Potential recall and response bias.
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From page 68... ...
2004. Georgia Behavioral Risk Factor Surveillance System, 2002 Report.
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From page 69... ...
practice In 2002, 23.2 percent of adults in Georgia smoked cigarettes. Approach to calculating the measure Numerator Number of adult smokers whose doctor, nurse, or other health professional recommended or discussed medication to assist quitting smoking in the past year Denominator All adult smokers Potential data sources Behavioral Risk Factor Surveillance System Comments Adults include all persons aged 18 and older.
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From page 70... ...
2004. Georgia Behavioral Risk Factor Surveillance System, 2002 Report.
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Approach to calculating the measure Numerator Number of adults aged 18 and older who have a BMI 30 kg/m2 Denominator Number of adults aged 18 and older Potential data source(s) Behavioral Risk Factor Surveillance System Comments BMI is calculated from self-reported height and weight.
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Approach to calculating the measure Numerator Number of new cancer cases Denominator Total Georgia population Potential data source(s) Georgia Comprehensive Cancer Registry Comments Incidence rate = (New cancers/Population)
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From page 73... ...
practice In 2000, Georgia's breast cancer incidence rate was 125.6 per 100,000; nationally it was 128.9 per 100,000. Approach to calculating the measure Numerator Number of new breast cancer cases Denominator Number of females in Georgia Potential data source(s)
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From page 74... ...
Limitations Increasing incidence may reflect improvements in screening rates and technologies rather than a real increase in colorectal cancer, so incidence statistics may need to be interpreted with stage and mortality statistics. Incidence rates are long term indicators; substantial time must pass before GCC would have any impact on colorectal cancer incidence.
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From page 75... ...
Limitations Incidence rates are long-term indicators; substantial time must pass before GCC would have any impact on lung cancer incidence. Potential benchmark Surveillance, Epidemiology, and End Results Program; source(s)
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From page 76... ...
Limitations Increasing incidence may reflect improvements in screening rates and technologies rather than a real increase in prostate cancer, so incidence statistics may need to be interpreted with stage and mortality statistics. Incidence rates are long term indicators; substantial time must pass before GCC would have any impact on prostate cancer incidence.
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From page 77... ...
2004b. Behavioral Risk Factor Surveillance System, Prevalence Data: Georgia 2002 Colorectal Cancer Screening.
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From page 78... ...
2004. Georgia Behavioral Risk Factor Surveillance System, 2002 Report.
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