Studies Highlight Variation in Colorectal Cancer Care and Support Needs
Research found variation in guideline-concordant colorectal cancer care across hospitals and systems, while a separate study highlighted the role of specialized cancer nurses in reducing distress and improving support.
Colorectal cancer care varies across hospitals and health systems, and patients report emotional and practical challenges that can be eased by specialized cancer nurses. Research presented at the NCCN Annual Conference 2026 found variation in delivery of guideline-concordant colorectal cancer care, while a qualitative study in Supportive Care in Cancer described the value of consistent nursing support and clearer communication.
Using data from the hospitals of the Michigan Surgical Quality Collaborative and administrative claims from the Michigan Value Collaborative, researchers assessed guideline-concordant colorectal cancer care quality to quantify how much variation is attributable to hospitals or their broader health systems. Data from the Michigan Surgical Quality Collaborative included 3545 patients from 55 hospitals in 11 systems and were evaluated for outcome-based measures. Data from the Michigan Value Collaborative included 3789 patients from 52 hospitals in 11 systems and were assessed for process-based measures.
Process measures included preoperative staging measures of cross-sectional chest imaging, cross-sectional abdominopelvic imaging, serum carcinoembryonic antigen testing, and mismatch-repair protein testing. Outcome-based measures included positive surgical margins and inadequate lymph node examination, defined as fewer than 12 lymph nodes.
Levels of quality varied some across measures, hospitals, and systems. For mismatch-repair protein testing within 90 days before or after surgery, the mean adjusted rate of testing by system was 74.5%, and both high- and low-performing hospital systems were reflected in the dataset. Variance partitioning coefficients for hospitals and health systems were 22.8% and 13.2%, respectively, for mismatch-repair protein testing; 13.8% and 7.6%, respectively, for inadequate lymph node examination; and 14.3% and 3.7%, respectively, for cross-sectional chest imaging.
Other outcome measures showed lower variation in quality, with variance partitioning coefficients of 0.0% and 0.0% for hospitals and health systems, respectively, for positive surgical margins; 1.8% and 0.0%, respectively, for cross-sectional abdominopelvic imaging; and 5.1% and 0.0%, respectively, for serum carcinoembryonic antigen testing. The findings indicated that some health systems consistently deliver guideline-concordant colorectal cancer care for some measures and that the ways some health systems provide consistent adherence to guidelines may serve as a guide for other health systems.
In a separate exploratory qualitative study of patients with colorectal cancer in Australia, researchers examined the healthcare experience of patients facing physical and psychosocial challenges, including stigmas associated with bowel function and control. The impact was described as often exacerbated in Australia due to geographical barriers that can limit access to specialized cancer support services.
Researchers conducted semi-structured interviews with nine patients with colorectal cancer, including two men and seven women between the ages of 34 and 72 years. They identified four overarching themes: challenges navigating the healthcare system, including frustrations with delays, miscommunication, and fragmented care; the emotional impact of receiving a colorectal cancer diagnosis and undergoing treatment; the value of specialized cancer nurses and support networks to provide consistent empathetic reassurance and guidance; and physical and mental coping strategies, including mindfulness, physical activity, and dietary changes.
The study said ensuring continuity in nursing relationships is key to building trust and reducing emotional distress. Specialized cancer nurses provide an important sense of stability by proactively checking in with patients and providing clear information about care and support services. The researchers said cancer care systems should prioritize consistent models of specialist nursing support across hospital and community settings, with efforts focused on improving service availability in regional areas, strengthening nurse-patient continuity, improving communication pathways, and supporting informal coping efforts.