Ensuring quality cancer care

A follow-up review of the Institute of Medicine's 10 recommendations for improving the quality of cancer care in America


  • At The University of Texas MD Anderson Cancer Center: Tracy Spinks is Project Director, Institute for Cancer Care Excellence; Heidi W. Albright is Director, Institute for Cancer Care Excellence; Thomas W. Feeley is Vice President of Medical Operations, Helen Shafer Fly Distinguished Professor, and Division Head, Anesthesiology and Critical Care; Ron Walters is Associate Vice President, Medical Operations and Informatics; Thomas W. Burke is Executive Vice President and Physician-in-Chief; Thomas Aiola is Assistant Professor, Surgical Oncology; Eduardo Bruera is Department Chair, Palliative Care and Rehabilitation Medicine; Aman Buzdar is Professor, Breast Medical Oncology; Lewis Foxhall is Vice President, Health Policy; David Hui is Assistant Professor, Palliative Care and Rehabilitation Medicine; Barbara Summers is Vice President, Nursing Practice and Chief Nursing Officer; Alma Rodriguez is Vice President, Medical Affairs and Professor, Lymphoma; and Raymond DuBois is Provost and Executive Vice President. Kenneth I. Shine is Executive Vice Chancellor for Health Affairs for The University of Texas System.


Responding to growing concerns regarding the safety, quality, and efficacy of cancer care in the United States, the Institute of Medicine (IOM) of the National Academy of Sciences commissioned a comprehensive review of cancer care delivery in the US health care system in the late 1990s. The National Cancer Policy Board (NCPB), a 20-member board with broad representation, performed this review. In its review, the NCPB focused on the state of cancer care delivery at that time, its shortcomings, and ways to measure and improve the quality of cancer care. The NCPB described an ideal cancer care system in which patients would have equitable access to coordinated, guideline-based care and novel therapies throughout the course of their disease. In 1999, the IOM published the results of this review in its influential report, Ensuring Quality Cancer Care. The report outlined 10 recommendations, which, when implemented, would: 1) improve the quality of cancer care, 2) increase the current understanding of quality cancer care, and 3) reduce or eliminate access barriers to quality cancer care. Despite the fervor generated by this report, there are lingering doubts regarding the safety and quality of cancer care in the United States today. Increased awareness of medical errors and barriers to quality care, coupled with escalating health care costs, has prompted national efforts to reform the health care system. These efforts by health care providers and policymakers should bridge the gap between the ideal state described in Ensuring Quality Cancer Care and the current state of cancer care in the United States. Cancer 2011;. © 2011 American Cancer Society.