ASCO 2013: Location, location: Where you get cancer care matters

June 1, 2013 | by Nicole White

National Cancer Institute-designated comprehensive cancer center isn’t just a long, fancy name. For some young cancer patients, treatment at one of these centers could be the key to survival, a City of Hope study has found.

Adolescents and young adults who were treated at a National Cancer Institute-designated comprehensive cancer center fared much better than those treated at other institutions, City of Hope research has found. Adolescents and young adults who were treated at a National Cancer Institute-designated comprehensive cancer center fared much better than those treated at other institutions, City of Hope research has found.

The study compared 746 adolescents and young adults diagnosed with brain tumors in Los Angeles County, and analyzed their survival rates based on the facilities where they received care. The outcomes of patients from one of the county’s three NCI-designated centers were compared with those of patients who received care at other facilities in Los Angeles County.

“The reason why we wanted to do this particular study was we knew adolescents and young adults were less likely to have a favorable outcome – they haven’t kept up compared to patients under 14 years of age,” said Smita Bhatia, M.D., M.P.H., professor and Ruth Ziegler Chair in Population Sciences. “We wanted to see if their care had any role in it.”

For adolescents and young adults with very early stage brain tumors, the outcomes were good regardless of where they received treatment. Likewise, for those with very high-risk tumors, the outcomes were poor no matter where they were diagnosed and treated.

But for those in the middle, treatment location mattered. The gap between survival for young children versus adolescents and young adults disappeared when the adolescents and young adults were treated at an NCI-designated comprehensive cancer center.

For that group, it’s important that care be obtained at an NCI center, Bhatia said.

“Not only do [comprehensive cancer centers] provide multidisciplinary care to patients, but they do it using the most recent available evidence from research findings,” Bhatia said. “This is what gives them an edge over other centers.”

The study, led by Julie Wolfson, M.D., M.S.H.S. , assistant professor in the Department of Pediatrics, also found that adolescents and young adults who had a lower socioeconomic status or who were from a minority ethnic group were less likely to use an NCI-designated comprehensive cancer center.

“The next step is to look at what those barriers to access were, and why they couldn’t come,” Bhatia said. “It’s still very unclear how access to care at an NCI cancer center will be facilitated or how those barriers will be overcome with the new health care reform.”

The research is being presented in a poster session at the American Society of Clinical Oncology’s annual meeting in Chicago.

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under grant number K12 CA001727. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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