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ASCO Issues Recommendations for Improving Cancer Survivor Care in the United States

Statement calls for improved federal policies, physician education, clinical guidelines and research to optimize care for the nation's cancer survivors


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The American Society of Clinical Oncology (ASCO) has issued recommendations to help improve the quality of care for the more than 13 million cancer survivors living in the United States. ASCO's recommendations come at critical time when more people than ever before are surviving the disease as a result of advances in prevention, treatment and follow-up care.

Despite these important gains, cancer survivors still face a range of long-term challenges resulting from their disease and its treatment. Cancer survivors face an increased risk for other health problems, premature mortality and side effects from treatment. The transition from active treatment to post-treatment care is critical to optimal long-term health. If care is not planned and coordinated, cancer survivors are left without knowledge of their heightened risks and a follow-up plan of action.

"Most patients still want to see their oncologists even after they have finished active treatment. Oncologists are well positioned to lead and develop a strategy for coordinating follow-up care with primary care providers," said Sandra Swain, MD, FACP, ASCO president. "We can't let these patients, who are living examples of the progress we have achieved in cancer, fall through the cracks. ASCO's statement provides a roadmap for closing the gap in survivor care."

ASCO's statement, published today in the Journal of Clinical Oncology, outlines the components of cancer survivor care that should be prioritized by healthcare providers, patients, researchers and policymakers. The goal of this statement is to provide a framework to help ensure that the nation's cancer survivors receive the highest quality care possible, while addressing the unique needs and challenges faced by this population. 

"We can't let these patients, who are living examples of the progress we have achieved in cancer, fall through the cracks. ASCO's statement provides a roadmap for closing the gap in survivor care."

ASCO's Key Recommendations For Improving Survivor Care 

  • Promote patient-centered coordinated care through the use of shared-care models, which allow for collaboration among practitioners of different disciplines or with different skills and knowledge;
  • Increase adoption of quality improvement programs, such as ASCO's Quality Oncology Practice Initiative (QOPI®), which help physicians monitor and improve care for all survivors;
  • Expand research on long-term and late effects to expand the evidence base required to define optimal survivor care;
  • Strengthen education of healthcare providers on survivorship care to keep pace with growing evidence on the long-term follow-up care needs for different types of cancers;
  • Educate and empower cancer survivors and their families to advocate for their unique needs and to ensure optimal long-term health. 

"Our recommendations apply well beyond the immediate oncology community. As many patients transition back to their primary care and other providers, it is imperative that all healthcare professionals collaborate to ensure optimal care," said Mary MCabe, RN, MA, Chair of ASCO's Survivorship Committee and Director of the Cancer Survivorship Initiative at Memorial Sloan-Kettering Cancer Center.

Implementation: ASCO's Activities and Policy Recommendations

ASCO is working to implement the recommendations of its statement by:

  • Providing  educational sessions at its Annual Meeting and offering continuing medical education (CME) online;
  • Developing quality measures for survivor care, including the use of treatment plans that can be shared among each survivor's healthcare providers (oncologists, primary care doctor, etc.);
  • Developing clinical guidelines on long-term and late-effects often experienced by survivors, as well as on surveillance for cancer recurrence; and
  • Disseminating accurate, easy to read information on its patient website, Cancer.Net.

ASCO is also exploring partnership opportunities with primary and family physicians to develop additional guidance on how these physician groups can work with oncologists to improve the care of cancer survivors.

In addition, ASCO is also calling upon policymakers to ensure that the needs of cancer survivors remain a priority as provisions of the Patient Protection and Affordable Care Act are implemented. Portions of the law, including those addressing Accountable Care Organizations (ACOs) and patient-centered medical homes, hold promise for our nation's cancer survivors as they are designed to promote coordinated care for patients with chronic diseases. ASCO is calling on federal lawmakers to include cancer as a chronic disease under these provisions and acknowledge the long-term and multi-faceted health issues facing survivors.

ASCO is also calling for reform of the Medicare reimbursement system in order to adequately reflect the delivery of survivor-specific services. The lack of coding and reimbursement policies that reflect the range of care services for services remains a major barrier to implemented of care coordination. ASCO believes the Comprehensive Cancer Care Improvement Act has the capacity to address this issue by creating a Medicare reimbursement structure for cancer care planning and the development of coordinated cancer care plans.

The number of cancer survivors in the United States is at an all-time high. Today, two out of three people live at least five years after a cancer diagnosis, up from roughly one out of two in the 1970s. It is estimated that over the next ten years, the number of cancer survivors in the United States will reach more than 18 million, underscoring the importance of our strengthening our nation's health care system capacity to address cancer survivor care.

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For more information, visit Cancer.Net.