Prevalence and characteristics of cancer patients receiving care from single vs. multiple institutions

Introduction: Patients may receive cancer care from multiple institutions. However, at the population level, such patterns of cancer care are poorly described, complicating clinical research. To determine the population-based prevalence and characteristics of patients seen by multiple institutions, we used operations data from a state-mandated cancer registry. Methods and materials: 59,672 invasive cancers diagnosed in 1/1/2010-12/31/2011 in the Greater Bay Area of northern California were categorized as having been reported to the cancer registry within 365 days of diagnosis by: 1) >= 1 institution within an integrated health system (IHS); 2) IHS institution(s) and >= 1 nonIHS institution (e.g., private hospital); 3) 1 non-IHS institution; or 4) >= 2 non-IHS institutions. Multivariable logistic regression was used to characterize patients reported by multiple vs. single institutions. Results: Overall in this region, 17% of cancers were reported by multiple institutions. Of the 33% reported by an IHS, 8% were also reported by a non-IHS. Of non-IHS patients, 21% were reported by multiple institutions, with 28% for breast and 27% for pancreatic cancer, but 19%% for lung and 18% for prostate cancer. Generally, patients more likely to be seen by multiple institutions were younger or had more severe disease at diagnosis. Conclusions: Population-based data show that one in six newly diagnosed cancer patients received care from multiple institutions, and differed from patients seen only at a single institution. Cancer care data from single institutions may be incomplete and possibly biased. (C) 2016 Published by Elsevier Ltd.