In the report the IOM claims that a a number of factors – such as a growing demand for cancer care, the rising costs of this care, the complexity of the disease and its treatment and a shrinking workforce – are contributing to a coming crisis.
As is happening in other countries, a growth in the number of older people in the United States is leading to a rise in the number of people living with and beyond cancer. In the US, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. By 2022, it is projected that there will be 18 million cancer survivors and, by 2030, cancer incidence is expected to rise to 2.3 million new diagnoses per year.
The IOM report makes a number of recommendations for improving the quality of cancer care, based around ten goals.
One of these goals is to ensure that end of life care is consistent with patients’ values. To achieve this, the report recommends that:
- clinicians should receiving training in end of life communication
- cancer care teams should revisit and implement their patients’ advance care plans
- cancer care teams should provide palliative care and psychosocial support to patients with advanced cancer, and make timely referrals to hospice for end of life care when appropriate.
The report also calls for the incorporation of palliative care across the care continuum, and for patients to be better informed about the choices they have in terms of treatment options.
Tom Smith, MD, one of the report’s authors, refers to palliative care as “the home run of American medicine.” He explains: “First, people have better symptom management and quality of life. Second, people have fewer hospital days and hospitalisations at the end of life. Third base is people live at least as long, if not longer, with both hospice and palliative care. And fourth, it is care that we can actually afford.”
The ten goals of the recommendations are to:
- provide clinical and cost information to patients
- provide end of life care consistent with patients’ values
- have coordinated, team-based cancer care
- develop core competencies for the workforce
- expand breadth of cancer research data
- expand depth of cancer research data
- develop a learning health care IT system for cancer
- have a national quality reporting program for cancer care
- reduce disparities in access to cancer care
- improve the affordability of cancer care.
Download the report, Delivering high-quality cancer care: charting a new course for a system in crisis, from the IOM website.