A System in Crisis: Cancer care in America needs an overhaul, national report says

Cancer care in the United States is a system in crisis, according to a new report from the Institute of Medicine that says urgent changes are needed to boost the quality of care and improve outcomes for people diagnosed with the disease.

The report, prepared by an IOM committee chaired by UCLA's Dr. Patricia Ganz, attributes the crisis to the growing demand for cancer care among the aging baby boom generation, rapidly rising costs, a shrinking pool of cancer care professionals and dramatic changes in cancer therapies over the last decade that sometimes make it difficult to determine which patients should receive what treatment.

"We have a lot of waste in the system, where people are given treatments that are unnecessary and costly," said Ganz, director of cancer prevention and control research at UCLA's Jonsson Comprehensive Cancer Center and a professor of health policy and management at the UCLA Fielding School of Public Health. "So we're not just talking about underuse, we're talking about overuse as well. So the lack of coordination, the lack of the ability to evaluate the quality of care that you might receive, is what's missing in the health care delivery system today."

Ganz said changes across the board are needed and that all stakeholders in the cancer care community — from patients and researchers to care providers, payers and federal agencies — must work together to reevaluate their current roles and responsibilities in order to improve care, quality of life and outcomes.

In particular, the committee's report recommends working toward a system in which patients are engaged and informed, care is accessible and affordable, and the cancer care workforce is adequately staffed, trained and coordinated and provides evidence-based care. In addition, a firm focus must be placed on quality-measurement and performance improvement, improving health-care information technology, and translating research into clinical practice.

There are currently 14 million cancer survivors that live in the U.S. today — 4 percent of the population. More than 1.6 million new cases of cancer are diagnosed each year. By the year 2022, that number is expected to jump to 2.3 million.