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ASCO: Cancer patients’ access to quality health care ‘threatened’
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Increased cancer incidence will coincide with a decreasing number of oncologists and growing financial strain of community oncologic practices, according to ASCO’s “State of Cancer Care in America: 2014” report.
“We are here today out of a very specific concern that access to the care we have developed is currently being threatened,” Clifford A. Hudis, MD, ASCO president and chief of breast cancer medicine at Memorial Sloan-Kettering Cancer Center, said during a press conference. “Access to care means losing the possibility of the best possible outcomes and the highest quality of care that we have, in fact, demonstrated is out there and available, if we can get to it. We owe it to the 1.6 million Americans who will be diagnosed with cancer this year to address these problems.”
Clifford A. Hudis
The report — the first comprehensive assessment of its kind — estimates the number of US cancer cases will increase 45% by 2030, partially due to an aging population and screening practices. The current number of 13.7 million cancer survivors also is expected to increase to about 18 million.
“The number of cancers that were once fatal but are now are treatable or even curable continues to grow, and the number of patients who live with incurable cancer for longer periods of time continues to go up,” Hudis said. “This is one of the good problems that we have to confront.”
Despite the anticipated increases in cancer cases and survivors, the number of oncologists is only expected to increase by 28% through 2025, which will translate to a deficit of 1,487 oncologists. The shortage of oncologists may be worsened because 20% are older than 65 years and nearing retirement, and a survey conducted found oncologists increasingly experience burnout.
Cancer care costs are expected to increase to $173 billion in 2020 from $104 billion in 2006. However, the purchasing power of the NIH and the NCI have decreased 23% since 2003 due to medical inflation, Hudis said.
Finances pose a particular concern for small and mid-sized practices, according to the report.
Although 19% of Americans live in rural areas, only 3% of oncologists practice in these regions. A survey conducted among 8,000 oncologists found 63% of small practices — defined as having no more than two oncologists — expect to sell, merge or close their practice within the next year due to financial strain.
ASCO made several recommendations to confront these challenges.
The report’s authors support the repeal of the sustainable growth rate formula and Medicare sequestration. They also urge for the development of cancer care delivery and payment models. ASCO’s Quality Oncology Practice Initiative and CancerLinQ aim to provide personalized guidance on cancer treatment and quality of life care.
“The US cancer care system is among the best in the world; it is highly innovative, and it has delivered and led the innovations that have changed the outcomes of patients with cancer around the world,” Hudis said. “But at the same time, it really does face a near-perfect storm of challenges that could threaten its sustainability and specifically its ability to innovate and continue to lead. It’s a threat to access to care, and if you can’t get care, you can’t get good care. We have to figure out how to preserve access to care so patients can get the live-saving, live-preserving treatment that matters so much to us.” — by Alexandra Todak
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