ASCO Blueprint to Improve Cancer Survivor Care

Nick Mulcahy

January 08, 2013

The American Society of Clinical Oncology (ASCO) has issued recommendations to keep cancer survivors from falling "through the cracks." Those words, from ASCO president Sandra Swain, MD, refer to the health risks that imperil survivors as they transition out of treatment and the related need for planned and coordinated ongoing care to catch and mitigate those risks.

The more than 13 million cancer survivors in the United States are at increased risk for other health problems, premature mortality, and adverse effects from treatment, according to ASCO.

"As oncologists, we continue to see and care for patients long after they have completed active treatment. However, evidence shows that many patients are not getting the follow-up care they need," said Dr. Swain, who is from Georgetown University in Washington, DC, in a press statement.

"Oncologists are well positioned to lead and develop a strategy for coordinating follow-up care with primary care providers," she added.

ASCO's recommendations, published online January 8 in the Journal of Clinical Oncology, are "a roadmap for closing the gap in survivor care," she claimed. The paper outlines the components of cancer survivor care that should be prioritized.

According to the ASCO recommendations, the following key concepts should be promoted and/or expanded:

  • patient-centered coordinated care based on shared-care models, which allow for collaboration among practitioners of different disciplines

  • quality-improvement programs, such as ASCO's Quality Oncology Practice Initiative, to help physicians monitor and improve care

  • research on long-term and late effects

  • education of healthcare providers on survivorship care

  • empowerment of cancer survivors and their families to advocate for their needs and to ensure optimal long-term health.

The recommendations also have nitty-gritty proposals that address current healthcare politics.

For instance, ASCO asks policymakers to ensure that the needs of cancer survivors remain a priority as provisions of the Affordable Care Act are implemented.

Specifically, ASCO calls for federal lawmakers to include cancer as a chronic disease. This is important because portions of the new law, including those addressing Accountable Care Organizations and patient-centered medical homes, are designed to promote coordinated care for patients with chronic diseases, says ASCO.

ASCO also calls for reform of the Medicare reimbursement system to adequately reflect the delivery of survivor-specific services.

The lack of coding and reimbursement policies that reflect the range of care services remains a major barrier to the implementation of care coordination, says the organization. The Comprehensive Cancer Care Improvement Act could create a Medicare reimbursement structure for cancer care planning, according to ASCO.

Timely Paper

The number of cancer survivors in the United States is at an all-time high, says ASCO. And survival continues to improve. Currently, about 66% of patients live at least 5 years after a cancer diagnosis, which is an improvement from the 50% in the 1970s.

Over the next 10 years, the number of cancer survivors in the United States will exceed 18 million, which only increases the importance of cancer survivor care, says ASCO.

The organization says that it is working to implement the various recommendations by providing and/or further developing:

  • cancer survivorship educational sessions at its annual meeting and related continuing medical education online

  • quality measures for survivor care, including the use of treatment plans that can be shared by different types of healthcare providers

  • clinical guidelines on the long-term and late-effects often experienced by survivors and on surveillance for cancer recurrence

  • accurate, easy-to-read information on the Cancer.Net Web site for patients.

J Clin Oncol. Published online January 7, 2013. Full text