Report: Changes needed to ensure high-quality cancer care
April 6, 1999
WASHINGTON (CNN) -- A cancer advisory board of the Institute of Medicine (IOM) says system-wide changes are needed in the care of cancer patients.
According to a report released Tuesday by the National Cancer Policy Board, the overall quality of cancer treatment needs improvement. The report cites several studies to support its finding that survival rates for patients who need complicated cancer surgery or chemotherapy are two to three times higher in facilities that perform a high volume of these procedures than in hospitals that handle only a few such cases a year.
The board outlines what it considers to be an ideal system of cancer care. Many patients' care falls short of this ideal, according to the report. It finds many aspects of care varying from setting to setting because efforts to diagnose and treat cancer, along with coordinating and improving care, are determined by individual health care providers.
To boost overall quality, the report recommends the federal government and private health care providers be held to the board's new standards.
The report concentrates on the relationship between care delivery and treatment results in patients with breast cancer because that group has been extensively studied. Early detection has reduced breast cancer death rates by 20 percent in recent years.
In examining breast cancer statistics, the board found that mammography screening varies, depending on the technical quality of the image and the way it's interpreted. Other problems cited include under-use of mammography in early detection efforts; lack of adherence to professional standards of diagnosis; inadequate patient counseling about treatment options; and under-use of radiation therapy and chemotherapy after surgery.
The board also recommends that using quality-assurance mechanisms should be a requirement for receiving federal funding from Medicare and Medicaid. Six out of 10 new cancer cases are diagnosed in people aged 65 and older, a substantial impact on the Medicare system.
In addition to quality assurance mechanisms, the report addresses several issues in the care system. They include:
According to the IOM, some eight million Americans required some form of cancer care last year, including more than 1.2 million who were newly diagnosed.
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Institute of Medicine
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