title: Quality assurance in the treatment of colorectal cancer: the EURECCA initiative.
abstract: Colorectal cancer is one of the most common cancers in Europe. Over the past few decades, important advances have been made in screening, staging and treatment of colorectal cancer. However, considerable variation between and within European countries remains, which implies that further improvements are possible. The most important remaining question now is: when are we, health care professionals, delivering the best available care to patients with colon or rectal cancer? Currently, quality assurance is a major issue in colorectal cancer care and quality assurance awareness is developing in almost all disciplines involved in the treatment of colorectal cancer patients. Quality assurance has shown to be effective in clinical trials. For example, standardisation and quality control were introduced in the Dutch TME trial and led to marked improvements of local control and survival in rectal cancer patients. Besides, audit structures can also be very effective in monitoring cancer management and national audits showed to further improve outcome in colorectal cancer patients. To reduce the differences between European countries, an international, multidisciplinary, outcome-based quality improvement programme, European Registration of Cancer Care (EURECCA), has been initiated. In the near future, the EURECCA dataset will perform research on subgroups as elderly patients or patients with comorbidities, which are often excluded from trials. For optimal colorectal cancer care, quality assurance in guideline formation and in multidisciplinary team management is also of great importance. The aim of this review was to create greater awareness and to give an overview of quality assurance in the management of colorectal cancer.
authors.affiliation: Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Breugom
authors.affiliation: Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: P G
authors.initials: PG
authors.lastname: Boelens
authors.affiliation: Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: C B M
authors.initials: CB
authors.lastname: van den Broek
authors.affiliation: Department of Haematology and Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Cervantes
authors.affiliation: Department of Gastroenterology/Section of Digestive Oncology, University Hospital Leuven, Leuven, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Van Cutsem
authors.affiliation: Department of Oncology/Haematology, Martin-Luther-University Halle, Halle (Saale), Germany.
authors.forename: H J
authors.initials: HJ
authors.lastname: Schmoll
authors.affiliation: Department of Radiotherapy, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Valentini
authors.affiliation: Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands c.j.h.van_de_velde@lumc.nl.
authors.forename: C J H
authors.initials: CJ
authors.lastname: van de Velde
mesh_terms: D054869:Clinical Audit; D002986:Clinical Trials as Topic / Q000592:standards; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000628:therapy*; D003627:Data Interpretation, Statistical; D005060:Europe / Q000453:epidemiology; D005246:Feedback; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care / Q000592:standards
keywords: audit; colorectal cancer; guidelines; multidisciplinarity; quality assurance