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

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.