Comparison of Commission on Cancer-approved and -nonapproved hospitals in the United states: Implications for studies that use the National Cancer Data Base

Karl Y. Bilimoria, David J. Bentrem, Andrew K. Stewart, David P. Winchester, Clifford Y. Ko

Research output: Contribution to journalArticle

189 Scopus citations


Background: The Commission on Cancer (CoC) designates cancer programs on the basis of the ability to provide a wide range of oncologic services and specialists. All CoC-approved hospitals are required to report their cancer diagnoses to the National Cancer Data Base (NCDB), and the cancer diagnoses at these hospitals account for approximately 70% of all new cancers diagnosed in the United States annually. However, it is unknown how CoC-approved programs compare with non - CoC-approved hospitals. Methods: By using the American Hospital Association Annual Survey Database (2006), CoC-approved and non - CoC-approved hospitals were compared with respect to structural characteristics (ie, accreditations, geography, and oncologic services provided). Results: Of the 4,850 hospitals identified, 1,412 (29%) were CoC-approved hospitals, and 3,438 (71%) were not CoC-approved hospitals. The proportion of CoC-approved hospitals varied at the state level from 0% in Wyoming to 100% in Delaware. Compared with non - CoC-approved hospitals, CoC-approved programs were more frequently accredited by the Joint Commission, designated as a Comprehensive Cancer Center by the National Cancer Institute, and affiliated with a medical school or residency program (P < .001). CoC-approved hospitals were less likely to be critical access hospitals or located in rural areas (P < .001). CoC-approved hospitals had more total beds and performed more operations per year (P < .001). CoC-approved programs more frequently offered oncology-related services, including screening programs, chemotherapy and radiation therapy services, and hospice/palliative care (P < .001). Conclusion: Compared with non - CoC-approved hospitals, CoC-approved hospitals were larger, were more frequently located in urban locations, and had more cancer-related services available to patients. Studies that use the NCDB should acknowledge this limitation when relevant.

Original languageEnglish (US)
Pages (from-to)4177-4181
Number of pages5
JournalJournal of Clinical Oncology
Issue number25
StatePublished - Sep 1 2009


ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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