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Influence of NCI Cancer Center Attendance on Mortality in Lung, Breast, Colorectal, and Prostate Cancer Patients

The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Hanover, NH, Tracy.L.Onega{at}dartmouth.edu, Norris Cotton Cancer Center, Lebanon, NH

Eric J. Duell

International Agency for Research on Cancer (IARC), Lyon, France, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Hanover, NH, Norris Cotton Cancer Center, Lebanon, NH

Xun Shi

Dartmouth College, Hanover, NH

Eugene Demidenko

Dartmouth Medical School, Hanover NH; and Norris Cotton Cancer Center, Lebanon, NH

Daniel Gottlieb

The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH

David C. Goodman

The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Hanover, NH

Some evidence links cancer outcomes to place of service, but the influence of NCI (National Cancer Institute) cancer centers on outcomes has not been established. We compared mortality for NCI cancer center attendees versus nonattendees. This retrospective cohort study included individuals with incident cancers of the lung, breast, colon/rectum, or prostate from 1998 to 2002 (N = 211,084) from SEER (Surveillance, Epidemiology, and End Results)—Medicare linked data, with claims through 2003. We examined the relation of NCI cancer center attendance with 1- and 3-year all-cause and cancer-specific mortality using multilevel logistic regression models. NCI cancer center attendance was associated with a significant reduction in the odds of 1- and 3-year all-cause and cancer-specific mortality. The mortality risk reduction associated with NCI cancer center attendance was most apparent in late-stage cancers and was evident across all levels of comorbidities. Attendance at NCI cancer centers is associated with a significant survival benefit for the four major cancers among Medicare beneficiaries.

Key Words: cancer • mortality • Medicare • Cancer Centers • cancer outcomes

This version was published on October 1, 2009

Medical Care Research and Review, Vol. 66, No. 5, 542-560 (2009)
DOI: 10.1177/1077558709335536


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