At University of Rochester Medical Center in New York, Bailey K. Hilty Chu, MD, and her colleagues have confirmed what many cancer patients intuitively understand: where you receive surgery can be as important as the surgery itself. Their research, published in the Journal of the American College of Surgeons, reveals that rectal cancer patients treated at hospitals accredited by the American College of Surgeons' National Accreditation Program for Rectal Cancer (NAPRC) face significantly lower odds of having cancer cells left behind after surgery—a critical factor in preventing the disease from returning.
Rectal cancer treatment is notoriously complex, involving intricate surgical precision and coordinated multidisciplinary care. When surgeons remove the affected tissue, even microscopic cancer cells lingering at the surgical margins can become seeds for future recurrence. This is why the researchers' findings matter: they show that institutional expertise and rigorous accreditation standards translate directly into better odds for patients.
Using data from the National Cancer Database, which tracks cases from over 1,500 facilities accredited by the American College of Surgeons Commission on Cancer, the team evaluated outcomes across hundreds of hospitals. Of the 800 hospitals included in the study, just 57 achieved NAPRC accreditation between 2018 and 2021—only 7.1 percent. Yet this small group made a measurable difference. Patients treated at accredited hospitals showed an 8.7 percent relative reduction in positive surgical margins, meaning cancer cells were less likely to remain at the edges of the tissue removed during surgery. In absolute terms, this represented a reduction of 1.1 percentage points, but in the context of a life-threatening illness, the difference is significant.
The improvements extended beyond the operating room. Accredited hospitals were more likely to conduct comprehensive presurgical testing, including blood tests for carcinoembryonic antigen (CEA), a protein that can be elevated in people with rectal cancer. When patients receive this test before surgery, it provides crucial information for treatment planning and helps clinicians monitor for recurrence afterward. NAPRC-accredited hospitals showed a 4.2 percent absolute increase in pretreatment CEA testing compared to non-accredited facilities, representing a 5 percent relative improvement.
Overall, 2,716 patients received care at NAPRC-accredited hospitals during the study period. Accreditation, as Ronald J. Weigel, MD, PhD, MBA, FACS, medical director of ACS Cancer Programs, explains in the study, means hospitals have met rigorous standards covering infrastructure, staff education and training, and procedural experience. These aren't cosmetic distinctions—they're concrete measures that reflect an institution's commitment to evidence-based care.
A companion study published in JAMA Surgery added another encouraging finding: accredited programs saw increased patient volume after achieving accreditation without fragmenting care, suggesting that hospital systems can make this investment without compromising access or coordination across the broader healthcare network.
For patients facing a rectal cancer diagnosis, the message is clear. This research underscores the importance of asking hard questions: Where will my surgery be performed? Is the hospital NAPRC-accredited? Has the surgical team treated many rectal cancer cases? These aren't abstract concerns—they can determine whether cancer stays gone.