March 2, 2015

Our approach to care is reducing disparities in colon cancer

Kaiser Permanente's continuing efforts to increase quality of care are making a measurable difference in reducing disparities associated with colon cancer survival rates, according to a recent study published in the Journal of Clinical Oncology.

In the study, researchers from Stanford University and the University of California, San Francisco reviewed more than 30,000 patient records in the California Cancer Registry, which includes Kaiser Permanente patients and patients who received care from other providers.

The researchers found that there were no racial/ethnic disparities in survival rates among Kaiser Permanente patients who had colon cancer. In addition, they found that compared to patients who received care outside of integrated health care systems, Kaiser Permanente patients received more evidence-based care — or care that followed best-practice guidelines, including appropriate surgery and stage-specific chemotherapy.

The integrated health care system’s "approach to care is associated with higher levels of evidence-based medicine, improved survival and reduced colon cancer disparity gaps," wrote lead author Kim. F. Rhoads, MD, MPH, assistant professor of surgery at Stanford University School of Medicine, and her co-authors. The integrated health care system "may represent an important model for improving cancer outcomes and addressing disparities."

Health disparities in colon cancer incidence and mortality are well documented. For example, in the United States, colorectal cancer disproportionately affects Blacks, who have higher incidence and mortality rates compared to whites, according to a National Cancer Institute study. From 2002 to 2006, the average annual incidence rate for colorectal cancer was 48.6 per 100,000 for white men and women combined, compared to 59.9 per 100,000 for Black men and women. The annual mortality rates for the same time period were 17.7 per 100,000 for white men and women, and 25.4 per 100,000 for Black men and women.

"This study highlights the results of one of the key areas of focus for Kaiser Permanente leadership — our commitment to excellence and equity," said Ronald Copeland, MD, Kaiser Permanente chief diversity and inclusion officer. "Through Kaiser Permanente's integrated health care model, our evidence-based group practices, and the deployment of culturally and linguistically adapted, patient-centric engagement strategies that inform health screening techniques we ensure that all of our patients receive the best care possible."

Million Hearts Campaign logoKaiser Permanente’s integrated model of care has proven effective across the health care delivery spectrum, including the areas of screening and blood pressure control. Last year Kaiser Permanente in Southern California led the nation in breast cancer screening rates for Medicare patients, ranking No. 1 out of nearly 400 Medicare health plans across the nation, according to the 2014 National Committee for Quality Assurance’s Quality Compass® data. In addition, over the last three years the U.S. Department of Health and Human Services designated three Kaiser Permanente regions (Southern California, Northern California and Colorado) as Million Hearts Hypertension Control Champions, an initiative that highlights health care organizations that have improved hypertension control rates across their entire patient population and have verifiable data documenting this improvement.

“The higher survival rates demonstrated for colorectal cancer show Kaiser Permanente’s commitment to world-class cancer care along every step of the patient journey— from our emphasis on prevention and high screening rates, through timely diagnosis and delivery of evidence-based treatments and into the years of survivorship,” said Joanne Schottinger, MD, colorectal cancer care champion and oncologist, Kaiser Permanente Southern California.

The colon cancer study's findings echo those of a recent study published in the New England Journal of Medicine, which showed that racial disparities between Black and white seniors covered by Kaiser Permanente in the western United States have been nearly eliminated for cardiac risks and diabetes markers, even as these disparities persisted among patients in managed health care systems in other regions of the United States.