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Association of Cancer Care Quality Certification With Survival Across Multiple Cancer Types: A Population-Based Cohort Study in Taiwan.

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Τίτλος: Association of Cancer Care Quality Certification With Survival Across Multiple Cancer Types: A Population-Based Cohort Study in Taiwan.
Συγγραφείς: Chiu HC; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.; Department of Obstetrics & Gynecology, West Garden Hospital, Taipei, Taiwan., Chiang CJ; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.; Taiwan Cancer Registry, Taipei, Taiwan., Jhuang JR; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan., Tsai DR; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.; Taiwan Cancer Registry, Taipei, Taiwan., Lin LJ; Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan., Wang JF; Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan., Lee WC; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.; Taiwan Cancer Registry, Taipei, Taiwan.; Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan.
Πηγή: International journal of cancer [Int J Cancer] 2026 Oct 01; Vol. 159 (7), pp. 1772-1779. Date of Electronic Publication: 2026 Apr 23.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0042124 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0215 (Electronic) Linking ISSN: 00207136 NLM ISO Abbreviation: Int J Cancer Subsets: MEDLINE
Imprint Name(s): Publication: 1995- : New York, NY : Wiley-Liss
Original Publication: 1966-1984 : Genève : International Union Against Cancer
Ιατρικοί όροι (MeSH): Neoplasms*/mortality , Neoplasms*/therapy , Quality of Health Care*/standards , Certification*, Taiwan/epidemiology ; Registries/statistics & numerical data ; Humans ; Female ; Male ; Aged ; Middle Aged ; Cohort Studies ; Adult ; Proportional Hazards Models
Περίληψη: Cancer remains a major global health burden. Taiwan launched the Cancer Care Quality Certification (CCQC) program in 2008; however, comprehensive evaluations of its association with survival across multiple cancer types remain limited. A total of 294,323 patients diagnosed with one of eight cancer types between 2011 and 2017 were identified from the Taiwan Cancer Registry Database. Overall survival among patients treated at certified versus non-certified hospitals was compared using Cox proportional hazards models incorporating a hospital-level shared frailty to account for institutional heterogeneity, adjusting for age, sex, stage, hospital level, geographic region, and treatment modalities. Treatment at certified hospitals was associated with lower all-cause mortality for colorectal (adjusted hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.83-0.93), lung (HR, 0.91; 95% CI, 0.87-0.96), and bladder cancers (HR, 0.79; 95% CI, 0.66-0.96). No statistically significant associations were observed for liver, female breast, cervical, uterine, or ovarian cancers. In this population-based study, the CCQC program in Taiwan is associated with improved survival for several major cancers, although the magnitude of association varied by cancer type. These findings suggest that certification may serve as a marker of institutional capacity for delivering high-quality cancer care and support the continued evaluation of certification programs as a potential strategy for strengthening cancer care systems.
(© 2026 UICC.)
References: J Formos Med Assoc. 2019 May;118(5):856-858. (PMID: 30773272)
Gesundheitswesen. 2019 Oct;81(10):801-807. (PMID: 29672814)
Innov Surg Sci. 2021 Apr 30;6(2):67-73. (PMID: 34589574)
Breast J. 2015 Sep-Oct;21(5):490-500. (PMID: 26130502)
Eur J Cancer. 2007 Apr;43(6):1002-10. (PMID: 17329094)
BMJ. 2012 Apr 26;344:e2718. (PMID: 22539013)
Breast. 2018 Aug;40:54-59. (PMID: 29698925)
Ann Hepatol. 2025 Jul-Dec;30(2):101943. (PMID: 40774397)
J Formos Med Assoc. 2021 Nov;120(11):2037-2041. (PMID: 34020856)
World J Surg Oncol. 2024 Jan 6;22(1):11. (PMID: 38183134)
Eur J Cancer. 2006 Oct;42(15):2459-62. (PMID: 16934974)
BMC Cancer. 2022 Jun 7;22(1):621. (PMID: 35672675)
Ann Surg Oncol. 2022 Apr;29(4):2527-2536. (PMID: 35067792)
JTO Clin Res Rep. 2023 Dec 26;5(2):100629. (PMID: 38322712)
BMJ. 2018 Oct 18;363:k4011. (PMID: 30337294)
World J Urol. 2021 Jan;39(1):5-10. (PMID: 32851440)
Onkologie. 2011;34(7):362-7. (PMID: 21734422)
Jpn J Clin Oncol. 2015 Mar;45(3):291-6. (PMID: 25601947)
Ann Oncol. 2006 Mar;17(3):457-60. (PMID: 16322114)
Ann Surg Oncol. 2010 Jun;17(6):1471-4. (PMID: 20180029)
CA Cancer J Clin. 2019 Jul;69(4):280-304. (PMID: 31099893)
Grant Information: MOST 111-2314-B-002-089-MY3 National Science and Technology Council; NSTC 114-2314-B-002-085-MY3 National Science and Technology Council; A1141107 Health Promotion Administration, Ministry of Health and Welfare
Contributed Indexing: Keywords: cancer registry; cancer survival; certification; health care quality
Entry Date(s): Date Created: 20260424 Date Completed: 20260803 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC13432430
DOI: 10.1002/ijc.70516
PMID: 42026743
Βάση Δεδομένων: MEDLINE
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  Data: Association of Cancer Care Quality Certification With Survival Across Multiple Cancer Types: A Population-Based Cohort Study in Taiwan.
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  Data: <searchLink fieldCode="AU" term="%22Chiu+HC%22">Chiu HC</searchLink>; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.; Department of Obstetrics & Gynecology, West Garden Hospital, Taipei, Taiwan.<br /><searchLink fieldCode="AU" term="%22Chiang+CJ%22">Chiang CJ</searchLink>; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.; Taiwan Cancer Registry, Taipei, Taiwan.<br /><searchLink fieldCode="AU" term="%22Jhuang+JR%22">Jhuang JR</searchLink>; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.<br /><searchLink fieldCode="AU" term="%22Tsai+DR%22">Tsai DR</searchLink>; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.; Taiwan Cancer Registry, Taipei, Taiwan.<br /><searchLink fieldCode="AU" term="%22Lin+LJ%22">Lin LJ</searchLink>; Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan.<br /><searchLink fieldCode="AU" term="%22Wang+JF%22">Wang JF</searchLink>; Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan.<br /><searchLink fieldCode="AU" term="%22Lee+WC%22">Lee WC</searchLink>; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.; Taiwan Cancer Registry, Taipei, Taiwan.; Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan.
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  Data: <searchLink fieldCode="JN" term="%220042124%22">International journal of cancer</searchLink> [Int J Cancer] 2026 Oct 01; Vol. 159 (7), pp. 1772-1779. <i>Date of Electronic Publication: </i>2026 Apr 23.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Wiley-Liss%22">Wiley-Liss </searchLink><i>Country of Publication: </i>United States <i>NLM ID: </i>0042124 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1097-0215 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2200207136%22">00207136 </searchLink><i>NLM ISO Abbreviation: </i>Int J Cancer <i>Subsets: </i>MEDLINE
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  Data: <i>Publication</i>: 1995- : New York, NY : Wiley-Liss<br /><i>Original Publication</i>: 1966-1984 : Genève : International Union Against Cancer
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  Data: <searchLink fieldCode="MM" term="%22Neoplasms%22">Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Neoplasms+mortality%22">mortality</searchLink> <br /><searchLink fieldCode="MM" term="%22Neoplasms%22">Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Neoplasms+therapy%22">therapy</searchLink> <br /><searchLink fieldCode="MM" term="%22Quality+of+Health+Care%22">Quality of Health Care*</searchLink>/<searchLink fieldCode="MM" term="%22Quality+of+Health+Care+standards%22">standards</searchLink> <br /><searchLink fieldCode="MM" term="%22Certification%22">Certification*</searchLink><br /><searchLink fieldCode="MH" term="%22Taiwan%22">Taiwan</searchLink>/<searchLink fieldCode="MH" term="%22Taiwan+epidemiology%22">epidemiology</searchLink> ; <searchLink fieldCode="MH" term="%22Registries%22">Registries</searchLink>/<searchLink fieldCode="MH" term="%22Registries+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Cohort+Studies%22">Cohort Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Proportional+Hazards+Models%22">Proportional Hazards Models</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Cancer remains a major global health burden. Taiwan launched the Cancer Care Quality Certification (CCQC) program in 2008; however, comprehensive evaluations of its association with survival across multiple cancer types remain limited. A total of 294,323 patients diagnosed with one of eight cancer types between 2011 and 2017 were identified from the Taiwan Cancer Registry Database. Overall survival among patients treated at certified versus non-certified hospitals was compared using Cox proportional hazards models incorporating a hospital-level shared frailty to account for institutional heterogeneity, adjusting for age, sex, stage, hospital level, geographic region, and treatment modalities. Treatment at certified hospitals was associated with lower all-cause mortality for colorectal (adjusted hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.83-0.93), lung (HR, 0.91; 95% CI, 0.87-0.96), and bladder cancers (HR, 0.79; 95% CI, 0.66-0.96). No statistically significant associations were observed for liver, female breast, cervical, uterine, or ovarian cancers. In this population-based study, the CCQC program in Taiwan is associated with improved survival for several major cancers, although the magnitude of association varied by cancer type. These findings suggest that certification may serve as a marker of institutional capacity for delivering high-quality cancer care and support the continued evaluation of certification programs as a potential strategy for strengthening cancer care systems.<br /> (© 2026 UICC.)
– Name: Ref
  Label: References
  Group: RefInfo
  Data: J Formos Med Assoc. 2019 May;118(5):856-858. (PMID: <searchLink fieldCode="PM" term="%2230773272%22">30773272)</searchLink><br />Gesundheitswesen. 2019 Oct;81(10):801-807. (PMID: <searchLink fieldCode="PM" term="%2229672814%22">29672814)</searchLink><br />Innov Surg Sci. 2021 Apr 30;6(2):67-73. (PMID: <searchLink fieldCode="PM" term="%2234589574%22">34589574)</searchLink><br />Breast J. 2015 Sep-Oct;21(5):490-500. (PMID: <searchLink fieldCode="PM" term="%2226130502%22">26130502)</searchLink><br />Eur J Cancer. 2007 Apr;43(6):1002-10. (PMID: <searchLink fieldCode="PM" term="%2217329094%22">17329094)</searchLink><br />BMJ. 2012 Apr 26;344:e2718. (PMID: <searchLink fieldCode="PM" term="%2222539013%22">22539013)</searchLink><br />Breast. 2018 Aug;40:54-59. (PMID: <searchLink fieldCode="PM" term="%2229698925%22">29698925)</searchLink><br />Ann Hepatol. 2025 Jul-Dec;30(2):101943. (PMID: <searchLink fieldCode="PM" term="%2240774397%22">40774397)</searchLink><br />J Formos Med Assoc. 2021 Nov;120(11):2037-2041. (PMID: <searchLink fieldCode="PM" term="%2234020856%22">34020856)</searchLink><br />World J Surg Oncol. 2024 Jan 6;22(1):11. (PMID: <searchLink fieldCode="PM" term="%2238183134%22">38183134)</searchLink><br />Eur J Cancer. 2006 Oct;42(15):2459-62. (PMID: <searchLink fieldCode="PM" term="%2216934974%22">16934974)</searchLink><br />BMC Cancer. 2022 Jun 7;22(1):621. (PMID: <searchLink fieldCode="PM" term="%2235672675%22">35672675)</searchLink><br />Ann Surg Oncol. 2022 Apr;29(4):2527-2536. (PMID: <searchLink fieldCode="PM" term="%2235067792%22">35067792)</searchLink><br />JTO Clin Res Rep. 2023 Dec 26;5(2):100629. (PMID: <searchLink fieldCode="PM" term="%2238322712%22">38322712)</searchLink><br />BMJ. 2018 Oct 18;363:k4011. (PMID: <searchLink fieldCode="PM" term="%2230337294%22">30337294)</searchLink><br />World J Urol. 2021 Jan;39(1):5-10. (PMID: <searchLink fieldCode="PM" term="%2232851440%22">32851440)</searchLink><br />Onkologie. 2011;34(7):362-7. (PMID: <searchLink fieldCode="PM" term="%2221734422%22">21734422)</searchLink><br />Jpn J Clin Oncol. 2015 Mar;45(3):291-6. (PMID: <searchLink fieldCode="PM" term="%2225601947%22">25601947)</searchLink><br />Ann Oncol. 2006 Mar;17(3):457-60. (PMID: <searchLink fieldCode="PM" term="%2216322114%22">16322114)</searchLink><br />Ann Surg Oncol. 2010 Jun;17(6):1471-4. (PMID: <searchLink fieldCode="PM" term="%2220180029%22">20180029)</searchLink><br />CA Cancer J Clin. 2019 Jul;69(4):280-304. (PMID: <searchLink fieldCode="PM" term="%2231099893%22">31099893)</searchLink>
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  Data: MOST 111-2314-B-002-089-MY3 National Science and Technology Council; NSTC 114-2314-B-002-085-MY3 National Science and Technology Council; A1141107 Health Promotion Administration, Ministry of Health and Welfare
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  Data: <i>Keywords: </i>cancer registry; cancer survival; certification; health care quality
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