Evaluation of the quality of care of endometrial cancer in Belgium - EFFectiveness of Endometrial Cancer Treatment (EFFECT) project.

Cancer of the corpus uteri (uterine cancer) is the fourth most common cancer site in European women after breast, lung and colorectal cancer (From https://ecis.jrc.ec.europa.eu/, accessed on 05/09/2018). Every year around 1,500 new uterine cancer cases are diagnosed in Belgium. In comparison with other female cancers, such as breast or ovarian cancer, the evidence for the treatment of uterine cancer is rather limited. For instance, surgery is well-established as being the cornerstone of the treatment, the role of lymphadenectomy is controversial. Literature shows a high variability in the practices at all steps on the management of endometrial cancer. The best way to document variability and its consequence on outcome is to measure in a prospective way with the help of quality indicators. Therefore, the project EFFECT (EFFectiveness of Endometrial Cancer Treatment) was established between different stakeholders. At the moment, information of more than 4,100 new diagnosed uterine cancer patients (with follow-up data at 6 months and annually until 5 years) are registered in the EFFECT database. With all this information gathered, much more could be done to improve the quality of care of endometrial cancer patients. Therefore, 2 primary research questions will be addressed: What is the impact of hospital volume on patients treatment and outcome. And has the quality of care increased on a national level between the beginning of the EFFECT project and the subsequent years. In order to be confident that the conclusions are scientifically and methodologically correct an extensive data cleaning will be performed on the EFFECT database in order to detect and remove errors and inconsistencies in the data. Also, in order to assess to which extent EFFECT, a voluntary registration project, is representative for the Belgian population a completeness study will be performed. Therefore, the EFFECT database will be coupled with the Belgian Cancer Registry database where all women with a malignant uterine tumour are registered. The optimal goal is to acquire more uniformity in the treatment schemes and to achieve an optimal quality of care for every uterine cancer patient in an attempt to improve the outcome and quality of life.