HOSPITALS “FLUNK” IN THEIR EXAMINATION

OF COLON CANCER SURGERY PATIENTS

A new study from Northwestern University shows that hospital errors are rampant when it comes to making sure that colon surgery patients are cancer free. Most hospitals come up short when checking the prescribed number of lymph nodes to make certain there is no further spread of the disease.

Lymph nodes are checked following surgery to determine if the cancer might have spread beyond the treated area. During the past decade, oncology organizations have strongly recommended that at least 12 nodes should be checked. This helps in the process of determining if the cancer might still be present, allows for further diagnoses regarding the stage of the disease and provides evidence that contributes to future patient treatment decisions.

The study to determine if a correct diagnosis was occurring was conducted by the Northwestern University’s Feinberg School of Medicine and the American College of Surgeons. Nearly 1,300 U.S. institutions were studied to see if hospitals were complying with the 12 node check recommendation.

Of these 1,300 surgical service providers, more than 60 percent failed to comply with the recommendation to examine 12 lymph nodes. This error is particularly alarming as colon cancer is the second leading cause of cancer death in the United States. These results are now published in the

Journal of the National Cancer Institute.

“It’s disappointing that despite so much emphasis on this particular issue, so many hospitals still aren’t checking enough lymph nodes to ensure they diagnose the accurate state of cancer,” said Karl Bilimoirs, MD, the lead author and surgery resident at the Feinberg School. “Knowing the accurate stage of your disease affects your survival and treatment. That’s critical.”

An encouraging statistic from the study was that the lymph node checks have improved during the past decade. In 1996-97, only 15 percent of hospitals were doing the prescribed check. By 2004-2005, that number had risen to 38 percent. While this is an improvement, it still leaves about 65 percent of hospitals found to be not in compliance with the correct diagnosis techniques.

“Every surgeon has a story about a colon cancer patient where the pathology report showed only a few lymph nodes checked and no cancer was found,” said Dr. Bilimoria. “The surgeon asks the pathologist to check six or eight more nodes and one of those turns out to be positive for cancer. That completely changes the treatment plan.”

Armed with this information, a colon cancer patient can make certain that his or her hospital has not erred on the side of too few nodes checked. The patient should ask the surgeon if at least 12 have been checked and can ask for access to the full report of testing procedures to ensure hospital compliance. With 65 percent of all hospitals erring on the side of too few checks, this is vital information to know and use by a patient taking responsibility for a full recovery.

Source: Northwestern University. “Majority of Hospitals “Flunk” Colon Cancer.” September 2008.

http://www.northwestern.edu/newscenter/stories/2008/09/bilimoriacancer.html

 

 

 

 

 

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