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J Clin Oncol. 2013 Nov 10;31(32):4151-7. doi: 10.1200/JCO.2013.51.0651. Epub 2013 Oct 14.

Delivering high-quality and affordable care throughout the cancer care continuum.

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Ya-Chen Tina Shih, University of Chicago, Chicago IL; Patricia A. Ganz, Denise Aberle, and Jim C. Hu, University of California at Los Angeles, Los Angeles, CA; Amy Abernethy, Duke University, Durham, NC; Justin Bekelman, University of Pennsylvania, Philadelphia, PA; Otis Brawley, American Cancer Society, Atlanta, GA; James S. Goodwin, University of Texas, Galveston, TX; Deborah Schrag, Dana-Farber Cancer Institute; and Jennifer S. Temel and Lowell Schnipper, Harvard Medical School, Boston, MA.


The national cost of cancer care is projected to reach $173 billion by 2020, increasing from $125 billion in 2010. This steep upward cost trajectory has placed enormous an financial burden on patients, their families, and society as a whole and raised major concern about the ability of the health care system to provide and sustain high-quality cancer care. To better understand the cost drivers of cancer care and explore approaches that will mitigate the problem, the National Cancer Policy Forum of the Institute of Medicine held a workshop entitled "Delivering Affordable Cancer Care in the 21st Century" in October 2012. Workshop participants included bioethicists, health economists, primary care physicians, and medical, surgical, and radiation oncologists, from both academic and community settings. All speakers expressed a sense of urgency about the affordability of cancer care resulting from the future demographic trend as well as the high cost of emerging cancer therapies and rapid diffusion of new technologies in the absence to evidence indicating improved outcomes for patients. This article is our summary of presentations at the workshop that highlighted the overuse and underuse of screening, treatments, and technologies throughout the cancer care continuum in oncology practice in the United States.

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