Assessing and Enhancing Survivorship Care

Overview

Currently, there are over 18 million cancer survivors in the United States (US). This number is expected to continue to increase, as more people are living longer after diagnosis given advances in treatment. Care needs for cancer survivors persist beyond primary treatment and include management or prevention of side effects, detection of recurrence or new cancers, and support for healthy behaviors (such as tobacco control and physical activity). As a result, survivors need risk-informed, coordinated, and often multidisciplinary long-term follow-up care. However, approaches to cancer survivorship care vary widely across the US.

Despite the existence of recommendations and long-term follow-up guidelines for some cancers, the lack of a national standard for cancer survivorship care has impeded advancements in research and clinical care, most notably with regards to ensuring equitable care, measuring care quality, and supporting reimbursement for components of care received. Recently, as part of the Cancer Moonshot and the President’s Cancer Cabinet, the National Cancer Institute (NCI) and Veterans Affairs (VA), in collaboration with several Health and Human Services (HHS) agencies developed the National Standards for Survivorship Care. These standards define the (1) essential health system policy and process components of survivorship care programs; and (2) outcomes to evaluate the quality of survivorship care. The process to develop these standards included a landscape review of relevant guidelines, literature, quality frameworks, and prior work outside of the US, as well as national consensus meetings of subject matter experts to prioritize indicators. The final standards are being piloted in VA National TeleOncology’s new comprehensive survivorship program, which is scheduled to be implemented in 2024.

The short-term goal of the supplemental funding is to support research to better define and improve survivorship care that is accessible by survivors within each cancer center or organization’s catchment area using the national standards as a framework.