ASCO report: Despite progress in cancer care, access is at risk

Cancer patients are living longer than ever before, and have access to more treatment options for cancer with the knowledge that hundreds of cancer therapies are now in in research and development. But, despite “significant” progress in the fight against cancer, the American Society of Clinical Oncology’s (ASCO) report, “The State of Cancer Care in America: 2015,” points out that “profound changes occurring in the cancer care practice landscape …threaten patient access to these advances.”

According to the report, which was released Tuesday, the Food and Drug Administration last year added 10 new treatments to its arsenal of more than 170 approved anti-cancer agents (as well as four new medical devices and tests designed to positively affect outcomes through the earlier detection of cancers). In addition, more than 770 cancer therapies are now in research and development.

The news is also promising when it comes to cancer survival. More than two-thirds of patients diagnosed with cancer live beyond five years after their diagnosis, compared to just 49 percent in 1975. This, of course, means that the healthcare system is also dealing with an increasing number of cancer survivors.

That’s just one of the challenges the healthcare system faces concerning cancer care moving forward. According to ASCO report, other challenges include:

• Growing cancer care demand. An aging population will help account for an expected 45 percent increase in cancer incidence by 2030. And the growing obesity epidemic is expected to result in hundreds of thousands of additional cancer cases as well.
• Disparities in access to cancer care. The benefits of cancer screening and treatment advances haven’t been equitable among different ethnical and racial groups. For example, African-Americans are 2.5% more likely to develop cancer than white Americans, and 19.6% are more likely to die from it.
• The ability of the oncology workforce to handle demand for cancer care services. While there are now 11,700 oncologists available to provide patient care, about one-fifth of them are over 64 years of age, which suggests that the number of oncologists now in training won’t be enough to replace physicians who are retiring. Additionally, the ASCO report noted that minorities are poorly represented when it comes to the oncology workforce. Just 2.3 percent of practicing oncologists and 4 percent of oncology fellows are African American, while just 3 percent of practicing oncologists and 5.8 percent of oncology fellows are Hispanic. There are also concerns about the ability to provide oncology coverage to rural Americans as few new physicians choose to practice in non-urban areas. Finally, professional burnout remains a serious problem, with data showing that one-third of oncology fellows experience burnout and do not expect to work as many hours as their senior colleagues. F
• Oncology practice economic pressure. The report voices concerns about costs, shifting payment models, practice consolidation, and the administrative burden placed on practices due to  patient insurance issues (particularly preauthorization).

Moving forward, ASCO recommends that Congress take a number of steps to avoid any disruption to the cancer care system and “ensure that all patients with cancer have access to high-quality care.”

These include the immediate repeal of the sustainable growth rate and its replacement with a system that incentivizes the delivery of high-quality care; increasing the budgets of the National Institutes of Health and the National Cancer Institute by at least $32 billion and 5.32 billion, respectively; and passing legislation that would “ensure interoperability of medical records and provide the resources to enable practices to track and report quality measures, while serving patients in an environment of widespread change in care delivery and payment systems."