Sometimes we take for granted what goes on behind the scenes to improve the care offered to patients with cancer.
Having spent two days in Chicago attending meetings of the Commission on Cancer recently, I think it is worth highlighting and commending the work done by this very special organization and the volunteers and staff who make it possible—and successful as well.
Cancer is a complex disease. And it is no secret that not every person with cancer either can or even wants to be treated at a major research center when diagnosed with cancer. That means many of us with cancer are treated locally, some in large “megasystem” hospitals that are popping up across the country to much smaller institutions like the one that serves my hometown community in South Georgia.
But when you walk in the door, do you ever wonder who does the check-up to be certain that the hospital meets acceptable standards of cancer care? Is there anyone watching the store?
For more than 1500 hospitals across the country, that organization is the Commission on Cancer (CoC). Established by the American College of Surgeons in 1922, the Commission on Cancer develops standards to ensure high quality, comprehensive care for cancer patients. The American Cancer Society is a member organization of the Commission on Cancer and has provided funding to support activities of the Commission since 1926.
It isn’t an easy or simple process to achieve accreditation by the Commission on Cancer. There are well documented and researched standards which have to be met. Data has to be collected and analyzed, with frequent feedback to the hospitals, the doctors and the administrators. CoC-accredited hospitals know where they stand compared to other hospitals when it comes to appropriate care, follow-up, and medical practice. They must have a committee that oversees their cancer programs, and regular tumor conferences review cases in some circumstances weekly at a regularly scheduled cancer conference.
None of this happens in a vacuum. The CoC relies on dedicated staff and volunteers—including a large number of actively practicing physicians—to supply the backbone that makes all of this work. There are standards to write and maintain to be certain they are up to date. There is data that has to be collected by each participating hospital, accomplished by specially trained local cancer registrars who have to track down the information needed to keep the statistics accurate and current. There are surveyors—specially trained physicians—who travel to each site at least once every three years to review the performance of each institution.
The result of all of this activity is an oversight process that usually functions pretty much in the background but makes certain that the cancer care offered at many hospitals around the country meets acceptable standards. You may not know it’s there, but when it is, it offers another layer of assurance that the doctors and staff at that particular hospital care about what they do, and are making the effort to meet the standards of the Commission on Cancer.
One other point that frequently goes unnoticed is the data collected by CoC-accredited hospitals in the National Cancer Data Base. The National Cancer Data Base (NCDB), a joint program of the Commission on Cancer and the American Cancer Society, contains data on over 70 % of all cancer cases in the United States. Data collected in the NCDB allows researchers—including those at the American Cancer Society—to can gain insights into patterns of care that are important to understanding the cancer treatment landscape in the United States.
One of the unique aspects of this massive data collection effort is that it is the only nationwide cancer registry that includes information on insurance coverage—or lack thereof. For example, a decade ago that information provided researchers at the American Cancer Society with the ability to understand how important insurance coverage was to impacting the outcomes of cancer treatment: no insurance or limited insurance was associated with much worse treatment outcomes compared to those with insurance. This was important knowledge that literally helped moved the needle on helping uninsured Americans gain access to needed cancer care.
So let’s consider the activities of the Commission—with the support of the American Cancer Society, among others—another “unsung hero” of assuring that we all receive effective, quality cancer care.
Like everything else, we can and must continue to improve. We need to appreciate that the Commission on Cancer and the staff and volunteers who support its important mission help guide us on that path of improved cancer care quality in many hospitals in this great nation.
The Commission on Cancer is an important piece of the puzzle to assure us that we have someone who is literally “covering our backs” at a time when we need it most. The American Cancer Society along with many others is grateful for their efforts.