Lung and colorectal cancer treatment and outcomes in the Veterans Affairs health care system

Abstract

Leah L Zullig,1,2 Christina D Williams,3,4 Alice G Fortune-Britt1,51Center for Health Services Research and Development in Primary Care, Durham Veterans Affairs Medical Center, 2Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, 3Medical Service, Division of Hematology-Oncology, Durham Veterans Affairs Medical Center, 4Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, 5Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC, USAAbstract: Lung cancer (LC) and colorectal cancer (CRC) are the second- and third-most commonly diagnosed cancers in the Veterans Affairs (VA) health care system. While many studies have evaluated the treatment quality and outcomes of various aspects of VA LC and CRC care, there are no known reviews synthesizing this information across studies. The purpose of this literature review was to describe LC and CRC treatment (ie, surgical and nonsurgical) and outcomes (eg, mortality, psychosocial, and other) in the VA health care system as reported in the existing peer-reviewed scientific literature. We identified potential articles through a search of published literature using the PubMed electronic database. Our search strategy identified articles containing Medical Subject Headings terms and keywords addressing veterans or veterans' health and LC and/or CRC. We limited articles to those published in the previous 11 years (January 1, 2003 through December 31, 2013). A total of 230 articles were retrieved through the search. After applying the selection criteria, we included 74 studies (34 LC, 47 CRC, and seven both LC and CRC). VA provides a full array of treatments, often with better outcomes than other health care systems. More work is needed to assess patient-reported outcomes.Keywords: colorectal neoplasms, health services research, lung neoplasms, outcome assessment (health care), review, United States Department of Veterans Affairs