The health care system faces a crisis on how to deliver quality care to cancer patients because of an eroding oncology workforce, increasing treatment costs and annual diagnoses, according to a report from the Institute of Medicine.
The institute, which advises governments on health and medical issues, convened a committee of experts in 2012 to examine the quality of treatment for the 14 million cancer patients in the U.S. More than 16 million people are diagnosed with cancer annually, a rate the institute expects to rise by 45 percent to roughly 23 million new diagnoses per year by 2030.
"We have an aging population that will have a growing demand for cancer care," said oncology nurse Mary McCabe at an Institute of Medicine panel Tuesday. The group most susceptible to cancer – adults over the age of 65 – is expected to double by 2030, while the supply of oncologists will be short 2,550 to 4,080 physicians by 2020.
Meanwhile, astronomical treatment costs will continue to shut out patient access across the country. Cancer treatment increased from $72 billion to $120 billion between 2004 and 2010, and is expected to reach $173 billion by 2020, according to the report.
Though the five-year survival rate for all cancers increased from 49 percent between 1975 and 1977 to 68 percent between 2002 and 2008 according to the American Society of Clinical Oncology, treatment methods have had to become more complex to accommodate factors such as physiological changes and multiple coexisting diseases in patients.
"Probably on average the quality of care is not bad, but we know there are people who are not getting the [highest] standard of care," Patricia Ganz, co-author of the report and a University of California, Los Angeles professor, told Reuters. "Patients need to be asking, is my doctor giving me appropriate treatment?"
According to the report, only one of the 13 new treatments approved by the Food and Drug Administration last year was proven to extend the life of a patient for more than a median of six months. Each treatment cost more than $5,900 per month.
In order to improve the quality of patient care, the Institute of Medicine recommends more research to accommodate the growing diversity in patient diagnoses while supporting ongoing efforts to improve affordability and access to treatment. ASCO has guidelines for nearly every stage of every type of cancer that are not widely used by physicians, according to the report.