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Report: Changes needed to ensure high-quality cancer care


April 6, 1999
Web posted at: 1:05 p.m. EDT (1705 GMT)

In this story:

Report focuses on breast cancer studies

Board defines changes needed to improve system of care


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.

Report focuses on breast cancer studies

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.

Board defines changes needed to improve system of care

In addition to quality assurance mechanisms, the report addresses several issues in the care system. They include:

  • Pain management at end of life;
  • Enhancement of services for the under-insured and the uninsured;
  • More research to analyze the disparity between standard survival rates and treatment and those for members of some racial and ethnic minorities.

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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Medicare cost-cutting: Prostate treatments come under controls
December 15, 1998
Clinton proposes plan to cut Medicare costs, fraud
December 15, 1998
Seniors stress, as many HMOs quit Medicare program
November 6, 1998

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