March 21, 2023
The wide variability in the outcomes of rectal cancer management has been well recognized, but multidisciplinary care and adherence to evidence-based standards have been shown to improve treatment outcomes in many European countries. To address these outcome disparities in the US, the ACS and its Commission on Cancer began development of the National Accreditation Program for Rectal Cancer (NAPRC) in 2011. The initial NAPRC launched in 2017 with 22 standards, and the current standards document is available online. New research in Colorectal Disease shows that even in the interval between program development to program accreditation, before hospitals sought the NAPRC-approved designation, the standards were already making an impact.
Justin T. Brady, MD, and colleagues analyzed data from the National Cancer Data Base to find approximately 40,000 patients in the US with rectal cancer treated between 2011 and 2014. The study aimed to assess compliance with NAPRC standards before implementation of NAPRC accreditation. Compliance with all process and performance measures was achieved in only 28% and 56% of patients, respectively. Patients treated at "high-volume" centers (centers treating >30 patients per year) had higher odds (1.42) of having had all performance measures achieved. Importantly, the research suggests that completion of all process measures was association a significant reduction in patient mortality.
This publication provides further evidence for the importance of the NAPRC for patient outcomes and clearly demonstrates the major opportunity for improvement in rectal cancer care in the US.
Dr. Wexner is director of the Digestive Disease Institute at Cleveland Clinic Florida in Weston and a coauthor of the Colorectal Disease research study discussed in this article.