Aims
Comprehensive cancer centres (CCCs) are perceived as a hallmark of highest standard quality cancer care and research. However, variations exist across countries regarding key attributes, and no universal accreditation standards exist. Effectiveness of CCCs has also not been systematically synthesised. This review consists of i) a scoping review (ScR) to identify attributes and benefits of CCCs and ii) a systematic review (SR) to evaluate their effectiveness on patient outcomes.
Methods
The review was registered in PROSPERO (CRD42023387620) and prepared according to PRISMA guidelines. Searches were conducted in PubMed, Cochrane CENTRAL, and Epistemonikos for English articles from 2002 through January 2023. Articles were screened and assessed using JBI critical appraisal tools by two independent authors. Data were extracted by two authors, with results narratively synthesised, and meta-analysis conducted where appropriate.
Results
Of the initial 3,069 and 1,085 records screened for the ScR and SR, a total of 70 and 32 articles were included respectively. These were predominantly text and opinion journal articles (ScR) and observational cohort studies (SR). Most articles were conducted in the USA and Europe. Attributes of CCCs included a strong focus on research, education, collaboration, integrated care, and adherence to accreditation programs. Benefits included attracting high quality staff, increased research funding and outputs, development of and adherence to quality standards and improved access to care through hubs of networks. CCCs were found to be associated with better surgical margins and patient survival outcomes. Second opinions at CCCs also had the potential to alter cancer diagnoses.
Conclusions
CCCs are centres of excellence in cancer care, research, and education, commonly guided by accreditation standards. Benefits are perceived across the provider, organisation, and system levels. CCCs demonstrate improvements in patient outcomes. Findings from this review can inform future development and evolution of CCCs and accreditation programs in Australia and internationally.