Patterns of Care Studies


The Patterns of Care (POC) initiative has three inter-related goals, which are to:

  • Evaluate the dissemination of state-of-the-art cancer therapy and diagnostics into community oncology practice,
  • Identify patient-, provider-, and system-level factors that are associated with receipt and utilization of state-of-the-art cancer therapy and diagnostics in community oncology practice; and
  • Disseminate findings through scientific publications and presentations.

POC studies began in 1987 with SEERExternal Web Site Policy cases serving as controls for a study that examined the provision of state-of-the-art therapy in Community Clinical Oncology Program hospitals. In 1990, the number of cases included in the POC initiative was increased substantially to obtain more stable estimates of community practice in a population-based sample of cases.

POC data are collected under a Congressional Mandate to NCI (Public Law 100-607, Sec. 413 (a)(2)(C) adopted November 4, 1988), and the project is coordinated jointly by the Division of Cancer Control and Population SciencesExternal Web Site Policy and the Division of Cancer Treatment and DiagnosisExternal Web Site Policy.

Uses of POC/QOC data

Cancer is increasingly diagnosed and treated in the outpatient setting. POC studies provide important information on the receipt of cancer therapies that are not well documented in hospital records (Ex. hormonal therapy, immunotherapy, and chemotherapy).

Data gathered through the POC studies are used in many ways.

  • POC data help investigators examine disparities in receipt of cancer therapies, diagnostic tests, and biomarkers by age, race/ethnicity, and residential urbanicity/rurality.
  • POC data are used to show trends in cancer therapy and survival over time for sites with multi-year data. For example, data have been collected every 5 years for breast and colorectal cancer since 1987 and lung cancer since 1996.
  • POC studies are used in annual updates to the treatment chapter of the NCI's Cancer Trends Progress Report.

NCI has previously used the POC data to describe treatment for cancer sites and compare these with the guidelines for care.

POC findings on the dissemination of state-of-the-art therapy into community practice have been examined and linked to NIH Consensus Development Conferences StatementsExternal Web Site Policy and NIH Clinical AlertsExternal Web Site Policy.

These data have been presented to the Health and Medicine Division (formerly IOM)External Web Site Policy as a model for data collection to be used in evaluating the quality of cancer care.