Volume of Cancer Surgeries Performed in California Hospitals

This report provides patients who are facing cancer surgery at California hospitals with recent information that can be useful when deciding where to go for treatment. The report shows the annual number of cancer surgeries (“volume”) performed at every licensed California hospital. Information on 11 different cancer types is provided, including bladder, brain, breast, colon, esophagus, liver, lung, pancreas, prostate, rectal and stomach cancer. The report also provides information for healthcare providers, payers, public officials, and other stakeholders who make important decisions about cancer surgical care in California.

Why is the number of surgeries that a hospital performed important?#

For each of the cancer surgeries in this report, there is solid evidence in the clinical literature that supports a link between the number of surgeries hospitals perform and patient outcomes.  That is, patients who undergo treatment at hospitals that perform a small number of cancer surgeries are more likely to experience surgical complications or die, compared to patients operated on at high-volume hospitals. Because other factors such as cancer stage and physician and surgical team experience may play an equal or even greater role in patients’ outcomes, OSHPD does not endorse the use of cancer surgical volume as a stand-alone measure of hospital quality. However, volume information may prove useful to cancer patients and others in making more informed healthcare decisions.  Additional information about the link between the number of surgeries hospitals perform and patient outcomes can be found on the California HealthCare Foundation Website.

Considerations when making choices#

Cancer patients and their healthcare providers should take a number of things into account when deciding whether and where to have their cancer surgeries performed.  Patients need to identify and share their own values and preferences with their healthcare provider when choosing a course of treatment, including whether to have surgery at all.  In consultation with their doctor, balancing the risks and benefits of available options, patients should choose the most appropriate course of treatment for themselves.

Below are two bar graphs, with bars representing the number of cancer surgeries for each hospital.  The filters affect the bar graph on the left, so a specific type of cancer surgery, county and/or hospital can be viewed.  The results then can be compared to the bar graph on the right, which includes all the hospitals in California that performed at least one cancer surgery of a specific cancer type in 2019.

Number of Cancer Surgeries by Type of Cancer Surgery, County and Facility, 2019#

How can you use this information?#

When surgery is an option, the volume of surgeries a hospital performs for a particular cancer should be an important consideration for patients and healthcare professionals when making decisions about where to have surgery performed.  In the past, patients unaware of the link between volume and outcome may have had their surgeries performed locally to avoid the inconvenience of travel.  However, with the availability of this new information, some patients may choose, in consultation with their doctors, to travel to a hospital that performs more surgeries.  Currently, many patients are having cancer surgeries performed in hospitals that do a very small number of surgeries each year, potentially increasing their risk of poor outcomes.

Below is a series of line graphs which show the number of cancer surgeries for each facility from 2013 – 2019.  The filters affect the line graphs, so a specific type of cancer surgery, county and/or hospital can be viewed.

Number of Cancer Surgeries by Type of Cancer Surgery, County and Facility Over Time, 2013 – 2019#

Zero for the number of surgeries indicates no surgery for that type was performed during the specified year.
The number of surgeries is missing if a facility was not open during the specified year.

Other important quality information#

When considering cancer surgery at a California hospital, patients and their doctors should also seek other quality and patient safety-related information, including hospital rates for surgical deaths, complications, and unplanned readmissions.  Published information on hospital infection prevention, patient safety, and patient experience/satisfaction can also be useful.

Increased risk for older cancer patients#

Elderly patients and patients with additional medical complications should pay special attention to hospital volume and other patient safety information.  Research shows that these patients are at higher risk for poor outcomes at low-volume hospitals when compared to younger, healthier patients.

Methods for determining cancer surgical volume#

The methods used for selecting, identifying, and calculating the number of cancer surgeries at hospitals, along with more detailed technical explanations of information provided in the report, can be found in the Technical Note.