Choosing where to receive cancer treatment can be one of the most important decisions a patient makes. A new study now suggests that patients with rectal cancer may have better surgical outcomes when treated at hospitals with specialized accreditation programs.
Researchers found that hospitals accredited through the National Accreditation Program for Rectal Cancer, known as NAPRC, provided higher-quality care in several key areas compared with hospitals without accreditation.
The study was published in the Journal of the American College of Surgeons.
Rectal cancer develops in the lower part of the large intestine and can be difficult to treat because of the location of the tumor and the need for highly precise surgery. Treatment often involves a combination of surgery, radiation therapy, chemotherapy, medical imaging, and careful long-term monitoring.
Because rectal cancer care is so complex, hospitals must coordinate many different medical specialists to provide effective treatment. This includes surgeons, cancer doctors, radiologists, pathologists, nurses, and support staff.
To improve consistency and quality of care, the American College of Surgeons created the NAPRC accreditation program. Hospitals seeking accreditation must meet strict standards involving staff training, treatment planning, communication systems, patient monitoring, and surgical expertise.
Researchers wanted to examine whether these accreditation standards actually improved patient outcomes in real-world practice.
Using information from the National Cancer Database, the research team analyzed data from 800 hospitals between 2018 and 2021. The database contains information from more than 1,500 cancer treatment centers across the United States.
Only 57 of the hospitals included in the study had achieved NAPRC accreditation during the study period. Overall, 2,716 patients received treatment at accredited hospitals.
One major focus of the study was whether surgery successfully removed all cancer tissue.
Doctors examined something called the circumferential resection margin, or CRM. This refers to the outer edge of the tissue removed during rectal cancer surgery. If cancer cells are found at the edge, this suggests some cancer may have been left behind inside the body.
Positive surgical margins are considered dangerous because they are strongly linked to cancer recurrence.
The study showed that patients treated at accredited hospitals were less likely to have positive surgical margins than those treated at non-accredited hospitals.
After adjusting for differences between patient groups and hospitals, researchers found that accreditation was associated with an 8.7 percent relative reduction in positive surgical margins.
The study also examined how often patients received a blood test called carcinoembryonic antigen testing, or CEA testing, before treatment started.
CEA is a protein that can become elevated in some people with rectal cancer. Measuring it before surgery can help doctors track how well treatment works and monitor whether cancer returns later.
Researchers found that accredited hospitals were more likely to perform this important test before treatment. Pretreatment CEA testing rates improved from 84 percent at non-accredited hospitals to nearly 90 percent at accredited hospitals.
The study did not find meaningful differences in how quickly patients began treatment after diagnosis.
Study co-author Dr. Bailey K. Hilty Chu from the University of Rochester Medical Center explained that accreditation standards help ensure patients receive evidence-based care from experienced teams familiar with treating rectal cancer.
Researchers believe these findings may encourage more patients to seek care at specialized cancer centers.
A separate study published in JAMA Surgery found that accredited hospitals treated larger numbers of rectal cancer patients after gaining accreditation. Importantly, researchers did not find evidence that patient care became more fragmented as hospitals handled more cases.
This suggests that specialized programs may be able to expand treatment capacity while still maintaining coordinated care.
The researchers also suggested that accreditation programs may provide financial benefits to hospitals because patients may increasingly choose accredited centers for treatment.
For patients, the findings highlight the importance of asking questions about hospital experience and accreditation when considering treatment options. Specialized programs may offer stronger coordination, more experienced surgical teams, and better adherence to evidence-based treatment guidelines.
However, the researchers also acknowledged several limitations. The study was observational, meaning it cannot fully prove that accreditation directly caused the better outcomes. Some accredited hospitals may already have had stronger resources or more experienced teams before becoming accredited.
Still, the findings provide important evidence that specialized accreditation programs are linked to measurable improvements in rectal cancer care. The study supports the growing idea that cancer treatment quality may depend not only on the individual doctor but also on the systems, teamwork, and standards built into the hospital itself.
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Source: American College of Surgeons.
