Aim: Cancer quality performance indicators (QPIs) have been developed by international groups to provide evidence-based measurements that allow aspects of care to be assessed and compared. Little has been published in Australia on performance in relation to QPIs, which QPIs may be measured, and which may be locally relevant.
Methods: The Evaluation of Cancer Outcomes Registry records clinical information on cancer patients for the entire Barwon South Western Region (BSWR). During 2010 to 2012 there were 829 newly diagnosed breast cancer patients for the region. A selected set of QPIs (Scottish taskforce) were chosen to assess local patterns of breast cancer QPI compliance.
Results: QPI 1: Patients with stage I breast cancers should undergo Breast conserving therapy (BCT) whenever appropriate (Scottish taskforce recommendation 85% vs. BSWR rate 88%). QPI 2: Patients under 70 years undergoing BCT should receive post-operative radiotherapy within 1 year of diagnosis (recommendation 95% vs. BSWR rate 94%). QPI 3: Patients under 70 years with T1cN0M0 or Stage 2/3 triple negative breast cancers should receive chemotherapy within 1 year of diagnosis (recommendation 85% vs. BSWR rate 83%). QPI 4: Patients aged 50-70 years with node positive or G3 and ≥20mm breast cancer should receive adjuvant chemotherapy (recommendation 85% vs. BSWR rate 61%). QPI 5: Women under 70 yrs with T1b/cN0M0 or Stage 2/3 HER2 positive breast cancers should receive adjuvant anti-HER2 chemotherapy within 1 year of diagnosis (recommendation 90% vs. BSWR rate 93%).
Conclusion: It is feasible to collect and report QPIs that measure aspects of care. Different QPI frameworks exist and the choice of framework may influence ease of reporting and results. BSWR results compared to Scottish QPIs were generally in line with recommendations, although there may be variation in delivery of adjuvant chemotherapy (QPI 4), likely explained by ER status.