Aim
Ovarian cancer has the highest mortality of the gynaecological cancers. The aims of this study were to: determine if women with ovarian cancer in NSW are receiving care aligned with the national optimal cancer care pathway for women with ovarian cancer; determine where there are variations in care; and to ascertain factors contributing to variation.
Method
A clinical audit methodology was used to determine the extent of variation in care for women with primary ovarian, fallopian tube and peritoneal cancer in NSW against the national optimal cancer care pathway for ovarian cancer. Eligible cases were identified by the NSW Cancer Registry from the period 1 March 2017 to 28 February 2018.
Results
A medical record audit was completed on a cohort of 171 women. Four elements of adherence to the optimal cancer care pathway were examined: 86% of women were reviewed by a specialist gynaecological oncology multidisciplinary team; 56% of women received their first treatment in a specialist gynaecological oncology hospital; 54% of women received their first treatment within 28 days of their first specialist appointment and; 86% of women had their first surgery completed by a Gynaecological Oncologist. Logistic regression analysis identified factors impacting adherence included local health district of residence, FIGO stage and level of comorbidity.
Conclusions
This is the first study to determine the extent of variation in care in NSW against the national optimal cancer care pathway for ovarian cancer. These results highlight variation in the care women receive across NSW, with high levels of care aligned with multidisciplinary team access and gynaecological oncologist completing surgery, but lower levels of timely treatment and treatment in a specialist hospital. This information will assist the Cancer Institute NSW to identify activities to improve adherence to the national optimal cancer care pathway for ovarian cancer across NSW.