Study: The Mortality Rate for Cancer Procedures is Significantly Higher in One-Star Hospitals

A new study published in the JNCI Cancer Spectrum, finds that one-star hospitals have markedly higher rates of mortality in complex cancer surgeries juxtaposed hospitals with a five-star rating.

To conduct this study, researchers evaluated the Center for Medicare and Medicaid Services’ “Star Rating” system, which  is based on 62 measurements (e.g. mortality, readmissions, patient experience), but is not specific to any medical operation or patient population. They assessed 105,823 patients (65 years and older) who underwent complex cancer procedures at 3,146 hospitals between 2013 and 2016. The patients had all been diagnosed with cancer of the lung, colon, stomach, esophagus, or pancreas. This group captures an estimated 80% of all high-risk cancer surgeries.

A Troubling Find

The results showed the mortality rate over a 90-day period was associated with the star system, with the greatest difference observed between the 1-star (10.4%) and 5-star (6.4%) hospitals. However, these rates varied by surgery type. The researchers noted that these findings are consistent with prior studies that have found that the Center for Medicare and Medicaid Services’ star rating system correlates with surgical mortality. And yet, the overall effectiveness of this system in choosing hospitals for complex cancer surgeries appears to be modest (84 lives per year), relative to other proposed strategies.


“For complex cancer care, choosing the right hospital may be as important as choosing the right treatment.,” said Daniel Boffa, MD, in a press release about the study. “In order for patients to select the best hospital for their situation, they need access to understandable information regarding the safety and quality of hospital care. Unfortunately, the CMS star-rating system, while clear and easy to access, does not appear to distinguish the safest from the least safe hospitals with enough separation to reliably guide cancer patient choice for complex surgical care.”