Mount Sinai School of Medicine researchers presented a new study to evaluate the impact of a tracking and feedback registry on breast cancer surgery patients. Presented at the American Association of Cancer Research Annual Meeting in San Diego, the study shows that a tracking system is key to improving rates of medical oncology consultation, reducing rates of adjuvant treatment underuse, and eliminating racial disparity in treatment.
Women who do not see medical oncologists despite surgeons referrals are less likely to use post-surgical adjuvant treatment. Mount Sinai School of Medicine researchers Dr. Nina Bickell, Kruti Mohan, and colleagues addressed this issue at six New York City medical centers. They implemented a tracking and feedback registry aimed at closing the referral loop for patients, linking care from surgeon to oncologist. With the new tracking and feedback registry, surgeons were notified by phone and mail whether or not their patients subsequently visited an oncologist. The result was an increase in oncology consultations of breast cancer patients, and a decrease in adjuvant treatment underuse.
Despite the existence of effective adjuvant treatment for early stage breast cancer, women do not always receive it, particularly, minority women, said Dr. Nina Bickell, MD, lead investigator of study and Associate Professor of Health Policy at Mount Sinai School of Medicine. Primary treatment for breast cancer, surgery and varying combinations of radio-, chemo- and hormonal therapy, is delivered by different specialists and is often fragmented. Closing the gap between surgeon and oncologist is crucial to help reduce underuse of adjuvant treatment.
The registry was also key to reducing racial health disparities. The study showed that a tracking and feedback registry eliminated minority race as a risk factor for an oncology consultation or underuse of adjuvant therapy.
With this intervention, we were attempting to target the system failures, cases in which the surgeon recommended treatment, the patient did not refuse, but care did not ensue, said researcher Kruti Mohan, MPH, Executive Director of Alliance for Health Improvement, LLC and Senior Project Manager, Department of Health Policy at Mount Sinai School of Medicine. We found that once surgeons became aware that their patients were not using available therapy, they felt compelled to intervene and were equipped with the appropriate data to take action.