title: Prevalence and characteristics of cancer patients receiving care from single vs. multiple institutions.
abstract: 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.
  
  
  
  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 365days of diagnosis by: 1) ≥1 institution within an integrated health system (IHS); 2) IHS institution(s) and ≥1 non-IHS 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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Cancer Prevention Institute of California, Fremont, CA, United States; Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA, United States. Electronic address: tina@cpic.org.
authors.forename: Christina A
authors.initials: CA
authors.lastname: Clarke
authors.affiliation: Cancer Prevention Institute of California, Fremont, CA, United States; Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA, United States.
authors.forename: Sally L
authors.initials: SL
authors.lastname: Glaser
authors.affiliation: Cancer Prevention Institute of California, Fremont, CA, United States.
authors.forename: Rita
authors.initials: R
authors.lastname: Leung
authors.affiliation: Cancer Prevention Institute of California, Fremont, CA, United States.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Davidson-Allen
authors.affiliation: Cancer Prevention Institute of California, Fremont, CA, United States; Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA, United States.
authors.forename: Scarlett L
authors.initials: SL
authors.lastname: Gomez
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA, United States.
authors.forename: Theresa H M
authors.initials: TH
authors.lastname: Keegan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence