title: Quality of life of colorectal cancer patients in certified centers versus non-certified hospitals.
abstract: BACKGROUND
  Since 2006, in Germany colorectal cancer patients can be treated in certified colorectal cancer centers. The aim of this explorative study was to investigate whether there are differences in the quality of life (QoL) of colorectal cancer patients who were treated in certified versus noncertified centers.
  
  
  METHODS
  A total of 284 colorectal cancer patients participated in the study: 184 patients from certified colorectal cancer centers and 100 patients from noncertified centers. Data on QoL (using the Quality of Life Questionnaire of the European Organization for Research and Treatment of Cancer (EORTC-QLQ C30)), patient satisfaction, mental distress and sociodemographic data were assessed with a questionnaire in a written survey after the hospital stay. The moderating influence of patientrelated characteristics (e.g. age, sex, patient satisfaction, and psychological distress) and cancerrelated factors (Union internationale contre le cancer (UICC) stage) were tested.
  
  
  RESULTS
  On a descriptive level, patients from noncertified centers had a higher QoL in 5 subdimensions (higher physical and role functioning and less insomnia, appetite loss and financial difficulties). After adjustment, only 2 differences remained significant: physical functioning (p < 0.01) and role functioning (p = 0.02).
  
  
  CONCLUSIONS
  Structural improvements in the oncological care are not necessarily reflected in a better QoL of the patients treated in certified colorectal cancer centers. The findings are discussed in the context of the applied study design.
authors.affiliation: Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Germany. gregor.weissflog@medizin.uni-leipzig.de
authors.forename: Gregor
authors.initials: G
authors.lastname: Weissflog
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.forename: Alexandra
authors.initials: A
authors.lastname: Meyer
authors.forename: Christian
authors.initials: C
authors.lastname: Wittekind
authors.forename: Arne
authors.initials: A
authors.lastname: Dietrich
authors.forename: Arved
authors.initials: A
authors.lastname: Weimann
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
authors.forename: Jochen
authors.initials: J
authors.lastname: Ernst
mesh_terms: D000368:Aged; D002173:Cancer Care Facilities / Q000592:standards* / Q000706:statistics & numerical data; D002568:Certification / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015995:Prevalence; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome