Patterns of Care/Quality of Care Studies


The Patterns of Care/Quality of Care (POC) initiative has three inter-related goals:

  • evaluate the dissemination of state-of-the-art cancer therapy into community practice;
  • disseminate findings in scientific journals and professional meetings; and
  • work with professional organizations to develop educational or training opportunities to improve the use of state-of-the-art cancer therapy in community practice.

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. Patterns of Care studies provide important information on the receipt of cancer therapies that are not well documented in hospital records. Data on hormonal therapy, immunotherapy, and chemotherapy, especially, are not well documented. Data gathered through the POC studies are used in a number of ways. For example, the data help investigators examine disparities in cancer treatment among age, racial/ethnic groups, and urban/rural residents. They also provide information about the dissemination of new therapies into commmunity practice.

Using POC study data, SEERExternal Web Site Policy "Stat Chats" help explain other SEER data on incidence and mortality. Stat Chats are seminars presented yearly to inform the NCI director and staff about cancer incidence, treatment, and mortality.

Interventions to Improve Care

  • The studies provide national population-based information on treatment dissemination into community practice, possible determinants of dissemination, and variations in therapy. Such information is essential to identifying potential areas for educational programs to improve the quality of care that will be planned in collaboration with professional societies.
  • 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. POC studies also will be used to develop future editions of NCI's Cancer Trends Progress ReportExternal Web Site Policy; inform NCI's programmatic "Challenges" in emerging trends, quality of care, and health disparities; and to inform interested members of the lay, patient advocate, policy and research communities.