# Improved Survival with Improved NAPRC Compliance: A Single-Institution Experience

## TL;DR

Better compliance with rectal cancer care standards is linked to improved three-year survival rates.

## Contribution

Demonstrates a survival benefit from adhering to NAPRC standards in rectal cancer care.

## Key findings

- Patients with moderate or high compliance had significantly lower hazard ratios for mortality.
- Compliance with at least eight NAPRC standards was associated with a survival benefit.
- No significant differences in demographics or disease stage were found between compliance groups.

## Abstract

Background: The National Accreditation Program for Rectal Cancer (NAPRC) was developed in 2017. This study investigates three-year survival after diagnosis of rectal cancer as a function of compliance with NAPRC standards. Methods: A prospective database recorded compliance with 15 NAPRC standards for patients diagnosed August 2019 through August 2021. This database was retrospectively reviewed for compliance and three-year survival after diagnosis. Results: Three groups were identified (low, moderate, and high compliance) without significant difference in age (p = 0.662), sex (p = 0.919), race (p = 0.88), or disease stage (p = 0.166) between groups. Compared to the least compliant group, both moderate- and high-compliance groups had statistically significant lower hazard ratios (HR 0.22 and HR 0.12, respectively). Conclusions: Increased compliance led to a significant survival benefit. Rectal cancer patients who received care adherent to at least eight components of the NAPRC standards had a significant survival benefit three years after diagnosis compared to patients with less compliance.