Care at a Comprehensive Cancer Center – like City of Hope – saves lives

June 1, 2014 | by Hiu Chung So

Although comprehensive cancer centers — including City of Hope — are recognized by the National Cancer Institute for their robust clinical care, research and education programs, patients have had little way to compare those centers' outcomes and patient populations against other facilities'. Until now.

African Americans and cancer City of Hope researchers found that a number of factors, including race and ethnicity, are tied to a lower likelihood of getting treated at a comprehensive cancer center.

This question is addressed in a new City of Hope study which found that receiving cancer care at a comprehensive cancer center does indeed improve survival. The study also found that multiple factors — including ethnicity, insurance type and socioeconomic status — can affect a person's likelihood of being treated at a comprehensive cancer center.

The abstract of the study will be presented on June 2 by Julie Wolfson, M.D., M.S.H.S., assistant professor of City of Hope's Department of Pediatrics and Department of Population Sciences, at the American Society of Clinical Oncology's annual meeting in Chicago.

"To be designated as a comprehensive cancer center, an institution has to go through a rigorous approval process to ensure its quality in diagnosis, treatment, research and education," Wolfson said. "However, there have not been any studies on treatment site's effect on survival outcomes or demographic factors that can impact where a patient goes for treatment."

To investigate this topic, Wolfson and her colleagues analyzed data from more than 53,000 cancer patients in the Los Angeles County cancer registry from 1998 to 2008. Of this patient population, approximately 7 percent were treated at a comprehensive cancer center; the team compared this subset against patients treated in other settings to determine whether there were any significant differences in demographics and overall survival.

In the abstract, the authors reported that, after adjusting for clinical and demographic differences, patients who received cancer care at a comprehensive cancer center had a lower mortality rate than those who received care at other facilities. This improvement in survival was seen across multiple diagnoses, including cancers of the breast, lung, liver, stomach, pancreas and oral tissues.

But the researchers also found a number of factors that reduced the likelihood a patient would be treated at a comprehensive cancer center. Those factors included:

  • Residing more than nine miles from the nearest comprehensive cancer center (30 to 50 percent less likely, depending on cancer type)
  • Having public or no health insurance (10 to 60 and 40 to 90 percent less likely, respectively)
  • Lower socioeconomic status (40 to 60 percent less likely)
  • Having an African-American or Hispanic background (30 to 60 percent less likely)

Having identified these differences in outcomes and access, Wolfson plans to further study these barriers and explore strategies that can overcome them.


Meanwhile, newly diagnosed cancer patients should consider looking into multiple options — including getting second opinions — to find a treatment location and plan that they are comfortable with.


Find out more about City of Hope's Department of Population Sciences.

The abstract (#6541) is available ahead of the meeting on ASCO's website.

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