Sarah Temkin, MD, National Institutes of Health, Washington, DC, discusses a national survey of ovarian cancer care programs in the United States, identifying the needs of patients and informing quality improvement initiatives for these programs.

This study was presented at the 2021 ASCO Quality Care Symposium.

Transcript

The study started as part of a quality improvement project that was performed by the Association of Clinical Cancer Centers on identifying barriers and opportunities in ovarian cancer care. We know that the minority of women who are diagnosed with ovarian cancer receive guideline-concordant care.

A call for applications for a quality improvement project was sent out. The organizations and the institutions that responded to that call for applications were very heterogeneous. We looked at what those organizations had identified as barriers to high-quality care for patients with ovarian cancer as well as opportunities for quality improvement in this disease site.

In order for organizations to participate in this quality improvement project to be identified, a 20-question survey was created and developed by a steering committee. The steering committee was made up of gynecologic oncologists, pathologists, genetic counselors and a nurse navigator.

The instrument was designed to collect information about the cancer care programs and certain variables related to the number of ovarian cancer patients that were seen and the type of care that those ovarian cancer patients received while getting care at that organization.

The study that was presented at this meeting was an overview of what those 26 organizations who demonstrated interest in a quality improvement project related to ovarian cancer, what their organizational characteristics were. In total, we received 26 responses from organizations that were interested in participating in this quality improvement project.

The organizations were varied in terms of the type of setting where patients received care, in terms of the number of ovarian cancer cases that were seen per year as well as the availability of additional services, such as clinical trials, nutritional services, palliative care services.

One of the points from the study really demonstrated that enormous heterogeneity of care that's received by patients with ovarian cancer across the country. The survey also assessed what institutions and organizations viewed as the largest barriers to receipt of quality care as well as the opportunities.

Not surprisingly, most organizations were interested in improving the delivery of genetic counseling and genetic testing to patients with ovarian cancer. Another need that was the next most common-cited need in terms of delivery of quality care in ovarian cancer was access to clinical trials.

The results of the survey demonstrate how heterogeneous the care received by ovarian cancer patients across the country is. In some sites, nearly all patients with ovarian cancer are receiving genetic counseling and treatment, whereas in others, it was a minority of patients.

We know, nationally, it's about a third of patients who receive genetic counseling and treatment, despite recommendations for nearly a decade that all women with ovarian cancer receive genetic counseling and testing.

We also saw that there was a lot of interest in improving the quality of care that organizations are providing to patients with ovarian cancer. I think that's exciting. The amount of engagement that was seen regarding this quality improvement project makes me hope that we can improve the quality of care that patients with ovarian cancer receive.    

Smeltzer M, Dawkins M, Boehmer L, et al. Assessing Comprehensive Care Deficits in United States Ovarian Cancer Programs to Inform Quality Improvement Initiatives. Presented at: the 2021 ASCO Quality Care Symposium; September 25-26, 2021; Boston, MA, and virtual; Abstract 256.