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Outlining the Crisis in Cancer Care

  • Mary J. Milroy
Chapter

Abstract

The task of providing accessible, high-quality care to cancer patients is facing an increasing number of stresses and threatens to reach a crisis in the future. This literature review looks at these stresses. The US population increased 0.07% (2.2 million) in 2016. Aging is a major risk factor for cancer and the number of persons over 65 is projected to double by 2050. The needed increased workforce is not projected to be adequate. The increased complexity of cancer care creates the need for improved communication among providers and patients. The rising cost of health care has been unsustainable and solutions are controversial, changing, and unresolved. Quality is an essential component of cancer care but measures are in development and challenging to implement. Knowledge of these stresses can help cancer programs in their strategic planning as they prepare to face these challenges and work to provide quality cancer care.

Keywords

Cancer Aging Stresses Quality Workforce Cost 

References

  1. 1.
    United States Census Bureau. Tuesday December 20, 2016. Release number: CB16-214.Google Scholar
  2. 2.
    Ortman JM, Velkoff VA, Hogan H. An aging nation: the older population in the United States. Population Estimates and Projections. Current Population Reports. US Department of Commerce, Economics and Statistics Administration, US Census Bureau. 2014. p. 25–1140. https://www.census.gov/prod/2014pubs/p25-1140.pdf.
  3. 3.
    Pew Research Center. The changing face of America 1965–2065. www.pewresearch.org/ft_16-01-25_nextamerica_fig.2_1_495px/.
  4. 4.
  5. 5.
    Lifetime risk (percent) of being diagnosed with cancer by site and race/ethnicity:males, 18 SEER Areas, 2010–2012 (Table 1.16). http://seer.cancer.gov/csr/1975_2012/browse_csr.php?sectionSEL=1&pageSEL=sect_01_table.16.html and females, 18 SEER Areas, 2010–2012 (Table 1.17) http://seer.cancer.gov/csr/1975_2012/browse_csr.php?sectionSEL=1&pageSEL=sect_01_table.17.html.2014.
  6. 6.
    Lifetime risk (percent) of dying from cancer by site and race/ethnicity:males, Total US, 2010–2012 (Table 1.19) http://seer.cancer.gov/csr/1975_2012/browse_csr.php?sectopmSEL=1&pageSEL=sect_01_table.19.html and females, total US, 2010–2012 (Table 1.20) http://seer.cancer.gov/csr/1975_2012/browse_csr.php?sectionSEL=1&pageSEL=set_01_table.20.html.2014.
  7. 7.
    Serrano M. Unraveling the links between cancer and aging. Carcinogenesis. 2016;37(2):107.CrossRefPubMedGoogle Scholar
  8. 8.
    Li D, de Glas NA, Hurria A. Cancer and aging: general principles, biology, and geriatric assessment. Clin Geriatr Med. 2016;32(1):1–15.CrossRefPubMedGoogle Scholar
  9. 9.
    Marosi C, Koller M. Challenge of cancer in the elderly. ESMO Open. 2016;1(3):e000020. eCollection 2016.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Bluethmann SM, Mariotto AB, Rowland JH. Anticipating the “Silver Tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomark Prev. 2016;25(7):1029–36.CrossRefGoogle Scholar
  11. 11.
    Hutchins L, Unger J, Crowley J, Coltman C, Albain K. Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med. 1999;341:2061–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Feinstein A. The pre-therapeutic classification of co-morbidity in chronic disease. J Chronic Dis. 1970;23:45–469.CrossRefGoogle Scholar
  13. 13.
    Sarfati D, Koczwara B, Jackson C. The impact of comorbidity on cancer and its treatment. CA Cancer J Clin. 2016;66:337–50.CrossRefPubMedGoogle Scholar
  14. 14.
    Mohile S, Hurria A, Cohen H, Rowland J, Leach C, Arora N, et al. Improving the quality of survivorship for older adults with cancer. Cancer. 2016;122:2459–68.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Rowland J, Bellizzi K. Cancer survivorship issues: life after treatment and implications for an aging population. J Clin Oncol. 2014;32(24):2662–8.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Global Burden of Disease Cancer Collaboration. Global, Regional, and National Cancer Incidence, Mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524–48.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Mayer D, Nasso S, Earp J. Defining cancer survivors, their needs, and perspectives on survivorship health care in the USA. Lancet Oncol. 2017;18:e11–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Snyder C, Frick K, Herbert R, Blackford A, Neville B, Lemke K, et al. Comorbid condition care quality in cancer survivors: role of primary care and specialty providers and care coordination. J Cancer Surviv. 2015;9:641–9.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Mayer D, Shapiro C, Jacobson P, McCabe M. Assuring quality cancer survivorship care: we’ve only just begun. Am Soc Clin Oncol Educ Book. 2015:e583–91.CrossRefGoogle Scholar
  20. 20.
    Levit L, Smith A, Benz E, Ferrell B. Ensuring quality cancer care through the oncology workforce. J Oncol Pract. 2010;6(1):7–11.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    ASCO State of Cancer 2016. American Society of Clinical Oncology. 2016. doi:101200/JOP2015.010462.
  22. 22.
    ASCO. The State of cancer care in America 2017. Proc Am Soc Clin Oncol. 2017;13(4):e353–94.  https://doi.org/10.1200/JOP.2016.020743.CrossRefGoogle Scholar
  23. 23.
    CancerCare. CancerCare patient access and engagement report. New York: CancerCare; 2016.Google Scholar
  24. 24.
    Lyman G, Levine M. Comparative effectiveness research in oncology: an overview. J Clin Oncol. 2012;30(34):4181–4.CrossRefPubMedGoogle Scholar
  25. 25.
    Neuss M, Desch C, McNiff K, Eisenberg P, Gesme D, Jacobson J. A process for measuring the quality of cancer care: the quality oncology process initiative. J Clin Oncol. 2005;23(25):6233–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Tina Shih YC, Mullins Daniel C, Drummond M. The role of economic evaluation in meeting IOM’s recommendations on delivering high-quality cancer care. Value Health. 2014;17(5):497–500.CrossRefPubMedGoogle Scholar
  27. 27.
    Martin A, Hartman M, Washington B, Catlin A, The National Health Expenditures Accounts Team. National health spending: faster growth in 2015 as coverage expands and utilization increases. Health Aff (Millwood). 2017;36(1):166–76.CrossRefGoogle Scholar
  28. 28.
    Collins S, Rasmussen P, Beulet S, Doty M. The problem of underinsurance and how rising deductibles will make it worse: findings from the common wealth fund biennial health insurance survey, 2014. Issue Brief (Commonw Fund). 2015;13:1–20.Google Scholar
  29. 29.
    Kale H, Carroll N. Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors. Cancer. 2016;122:1283–9.CrossRefGoogle Scholar
  30. 30.
    Pisu M, Azuero A, Benz R, McNees P, Meneses K. Out-of-pocket costs and burden among rural breast cancer survivors. Cancer Med. 2017;6(3):572–81.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Bradley C. Economic recovery: a measure of the quality of cancer treatment and survivorship. Cancer. 2015;121:4282–5.CrossRefPubMedGoogle Scholar
  32. 32.
    Halpern M, Brawley O. Insurance status, health equity, and the cancer care continuum. Cancer. 2016;122:3106–9.CrossRefPubMedGoogle Scholar
  33. 33.
    Shih Y, Chien C. A review of cost communication in oncology: patient attitude provider acceptance, and outcome assessment. Cancer. 2017;123:928–39.CrossRefPubMedGoogle Scholar
  34. 34.
    Kaiser Family Foundation. “Key facts about the uninsured population” KFF.org. 2016. http://www.kff.org/uninsured/fact=sheet/key-facts-about-the-uninsured-population/.
  35. 35.
    Auter Z. U.S. Uninsured rate rises to 11.7%. www.news.gallup. July 10, 2017. Gallup and Healthways U.S. Uninsured Rate Rises to 11.7%. Healthcare. 2017. http://news.gallup.com/poll/213665/uninsured-rate-rises.aspx.
  36. 36.
    Jost T. First steps of repeal, replace, and repair. Health Aff. 2017;36(3):398–9.CrossRefGoogle Scholar
  37. 37.
    Institute of Medicine. Best care at lower cost: the path to continuously learning health care in America. 2012. http://www.nationalacademies.org/hmd/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx.
  38. 38.
    The National Academy of Sciences, Engineering and Medicine: Delivering high-quality cancer care: charting a new course for a system. 2013. http//nationalacademes.org/hmd/reports/2013/delivering-high-quality-cancer-care-charting-a-new-course-for-a-system-in-crisis.aspx.
  39. 39.
    Nekhlyudov L, Levit L, Hurria A, Ganz P. Patient-centered, evidence-based, and cost-conscious cancer care across the continuum: translating the Institute of Medicine report into clinical practice. CA Cancer J Clin. 2014;64:408–21.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mary J. Milroy
    • 1
  1. 1.Department of Surgery, Sanford School of MedicineUniversity of South DakotaVermillionUSA

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