The State of Cancer Care in America, 2014: A Report by the American Society of Clinical Oncology

American Society of Clinical Oncology

Corresponding author: Laura Trent, American Society of Clinical Oncology, 2318 Mill Rd, Ste 800, Alexandria, VA 22314; e-mail: laura.trent@asco.org.

A Message from ASCO's President

As oncologists, our fundamental responsibility is to ensure that all patients with cancer—no matter who they are or where they live—receive the best possible care. Today, we have more tools to help our patients than ever before. Thanks to our nation's history of investment in cancer research, we now have a greater understanding of the molecular basis of cancer and an array of new imaging capabilities, detection and diagnosis methods, drugs, surgical techniques, and radiation delivery systems that collectively enable many patients to live longer, healthier lives with or after cancer. Because of these advances, two thirds of Americans now live at least 5 years after a cancer diagnosis, as compared to only about half in the 1970s.

Our challenge—and the focus of this report—is to ensure that all Americans benefit fully from these advances. Presently, millions of people lack access to quality cancer care, and the demand for care is growing rapidly as a consequence of population growth, aging, and lifestyles, among other factors. Remarkable advances in molecular biology are making cancer care far more complex and expensive, even as it is more effective. This may create a need for even more cancer physicians and other oncology professionals than are being trained today.

As this report makes clear, to overcome these challenges, it will be essential for policymakers to recommit to the fight against cancer and make sustained investments in cancer research and care programs. It will also be necessary for cancer care professionals to be even more nimble and creative as we seek to bring valuable cancer advances to a growing number of patients.

This publication is the American Society of Clinical Oncology (ASCO) inaugural report to the nation on the state of cancer care in America. Going forward, ASCO's annual reports to the nation on the state of cancer care in America will track progress against cancer and examine the most important trends that affect the oncology community's ability to provide high-quality, high-value cancer care.

Improving the quality of cancer care has been ASCO's mission since its founding 50 years ago. We are working to improve cancer care through numerous programs and initiatives, as well as advocating for improved access to high-quality, high-value care. For example, we have established CancerLinQ, a groundbreaking health information technology initiative that will provide physicians with access to vast quantities of clinical data about real-world patients and help achieve higher quality, higher value cancer care. When deployed, CancerLinQ will specifically help ensure that patients with cancer receive the best possible care no matter where they receive treatment.

Cancer affects us all and it is expected to become the leading cause of death in the United States as our population ages over the next 16 years. In many respects, the work before us, such as improving care through new technologies and adapting to new health care financing models, are shared by all of medicine. Through our commitment to conquer cancer, and tackle the major challenges in the field, we will not only save millions of lives, but point the way forward in addressing many of the greatest health challenges facing our nation and the world.

Clifford A. Hudis, MD, FACP

ASCO President, 2013-2014

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Executive Summary

This is a time of extraordinary change and opportunity in cancer care. A dynamic and integrally related combination of scientific and technological advances, health care policy changes, and demographic shifts is reshaping virtually every aspect of oncology. This transformation has profound implications for millions of people with cancer and their families in the United States and around the world.

Representing nearly 35,000 oncologists and other oncology professionals who care for people with cancer, ASCO is committed to ensuring that Americans have access to high-quality, high-value cancer prevention and treatment services—and that all patients benefit fully from our nation's investments in cancer research.

In “The State of Cancer Care in America, 2014,” ASCO examines the many factors that affect our nation's ability to reach these goals, from current and projected demand for services and oncologist workforce supply to the full range of economic, regulatory, and administrative pressures that oncology practices face. This report also examines how a growing emphasis on quality measurement and demonstration of value, together with the rapid expansion of health information technology (HIT), stands to improve the care that patients receive.

ASCO presents this overview of the current state of cancer care in the United States with an eye to the future. The report includes recommendations intended for policymakers, cancer care professionals, researchers, and others with a stake in improving our nation's cancer care system.