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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
×

ASSESSING THE QUALITY OF CANCER CARE

AN APPROACH TO MEASUREMENT IN GEORGIA

Committee on Assessing Improvements in Cancer Care in Georgia

National Cancer Policy Board

Jill Eden and Joseph V. Simone, Editors

INSTITUTE OF MEDICINE AND NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
×

THE NATIONAL ACADEMIES PRESS
500 Fifth Street, N.W. Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by a contract between The Georgia Cancer Coalition and the National Academy of Sciences. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Library of Congress Cataloging-in-Publication Data

Assessing the quality of cancer care : an approach to measurement in Georgia / Committee on Assessing Improvements in Cancer Care in Georgia, National Cancer Policy Board ; Jill Eden and Joseph V. Simone, editors.

p. ; cm.

Includes bibliographical references.

ISBN 0-309-09569-7 (pbk.); ISBN 0-309-54814-4 (PDF)

1. Cancer—Patients—Care—Georgia—Quality control—Measurement. 2. Cancer—Georgia—Prevention—Quality control—Measurement. 3. Cancer—Diagnosis—Georgia—Quality control—Measurement. 4. Cancer—Treatment—Georgia—Quality control—Measurement. 5. Outcome assessment (Medical care)—Georgia.

[DNLM: 1. Neoplasms—Georgia. 2. Outcome Assessment (Health Care)—Georgia. 3. Quality Assurance, Health Care—Georgia. QZ 200 A846 2005] I. Eden, Jill. II. Simone, Joseph V. III. National Cancer Policy Board (U.S.). Committee on Assessing Improvements in Cancer Care in Georgia.

RC277.G4A87 2005

362.196′994′009758—dc22

2005007665

Additional copies of this report are available from the
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Copyright 2005 by the National Academy of Sciences. All rights reserved.

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

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COMMITTEE ON ASSESSING IMPROVEMENTS IN CANCER CARE IN GEORGIA

Joseph V. Simone (Chair), President,

Simone Consulting, Dunwoody, GA

Lawrence B. Afrin, Associate Professor of Medicine,

Medical University of South Carolina, Charleston, SC

Tim Byers, Professor of Epidemiology, Program Leader,

Clinical Cancer Prevention and Control, University of Colorado Health Sciences Center, Denver, CO

Vivien W. Chen, Director, Louisiana Tumor Registry, Head of Epidemiology Program,

School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA

Peter D. Eisenberg, Oncologist,

California Cancer Care, Greenbrae, CA

Barbara Given, University Distinguished Professor,

College of Nursing, Michigan State University, East Lansing, MI

Robert Hiatt, Director, Population Science, Deputy Director,

University of California San Francisco Comprehensive Cancer Center, San Francisco, CA

David Lansky, Director,

Health Program, Markle Foundation, New York, NY

Benjamin Littenberg, Henry and Carleen Tufo Professor of Medicine and Director of General Internal Medicine,

University of Vermont College of Medicine, Burlington, VT

Barbara J. McNeil, Ridley Watts Professor, Head of the Department of Health Care Policy,

Harvard Medical School, Boston, MA

Mack Roach III, Professor,

Department of Radiation Oncology, Medical Oncology and Urology, University of California San Francisco, San Francisco, CA

Consultant

Joseph Lipscomb, Chief,

Outcomes Research Branch, National Cancer Institute, Bethesda, MD (until August 2004)

Staff

Jill Eden, Study Director

Roger C. Herdman, Director,

National Cancer Policy Board

Elizabeth J. Brown, Research Assistant

Editor

Kerry B. Kemp

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
×

NATIONAL CANCER POLICY BOARD

Joseph V. Simone (Chair), President,

Simone Consulting, Dunwoody, GA

Ellen Stovall (Vice Chair), President and CEO,

National Coalition for Cancer Survivorship, Silver Spring, MD

Bruce W. Stillman (Vice Chair), President,

Cold Spring Harbor Laboratory, Cold Spring Harbor, NY

Jill Bargonetti, Associate Professor,

Department of Biological Sciences, Hunter College, New York, NY

Timothy Eberlein, Bixby Professor and Chairman,

Department of Surgery, Washington University School of Medicine, St. Louis, MO

Kathy Giusti, President,

Multiple Myeloma Research Foundation, New Canaan, CT

Karen Hersey, Senior Intellectual Property Counsel,

Massachusetts Institute of Technology, Cambridge, MA

Jimmie C. Holland, Chair,

Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY

William G. Kaelin, Professor of Medicine,

Harvard Medical School, Boston, MA

William W. McGuire, Chairman and Chief Executive Officer,

UnitedHealth Group, Minnetonka, MN

John Mendelsohn, President,

University of Texas, M.D. Anderson Cancer Center, Houston, TX

Kathleen Hardin Mooney, Professor,

University of Utah College of Nursing, Salt Lake City, UT

Patricia A. Nolan, Director,

Rhode Island Department of Health, Providence, RI

David Parkinson, Vice-President of Oncology,

Amgen, Inc., Thousand Oaks, CA

John D. Potter, Senior Vice President and Director,

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and

Professor of Epidemiology,

University of Washington, Seattle, WA

Louise Russell, Research Professor of Economics,

Institute for Health, Rutgers University, New Brunswick, NJ

Thomas J. Smith, Professor,

Division of Hematology, Medical College of Virginia at Virginia Commonwealth University, Richmond, VA

Robert C. Young, President,

American Cancer Society and Fox Chase Cancer Center, Philadelphia, PA

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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National Cancer Policy Board Staff

Roger C. Herdman, Director

Jill Eden, Senior Program Officer

Hellen Gelband, Senior Program Officer

Maria Hewitt, Senior Program Officer

Sharyl Nass, Senior Program Officer

Judith Wagner, Scholar-in-Residence

Penelope Smith, Research Associate

Kathryn Barletta, Research Assistant

Elizabeth J. Brown, Research Assistant

Mary Ann Pryor, Senior Program Assistant

Anike L. Johnson, Administrative Assistant

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Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:


Stephen B. Edge, Roswell Park Cancer Institute

Philip Huang, Texas Department of State Health Services

Elizabeth A. McGlynn, The RAND Corporation

Henry W. Riecken, University of Pennsylvania, Professor Emeritus

Barbara K. Rimer, Lineberger Comprehensive Cancer Center and School of Public Health, University of North Carolina at Chapel Hill

Nancy Weiss, Texas Cancer Registry

Rodger Winn, Clinical Consultant, National Quality Forum


Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Harold C. Sox, Annals of

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
×

Internal Medicine, American College of Physicians of Internal Medicine, and Melvin Worth, Scholar-in-Residence, Institute of Medicine. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
×

Acknowledgments

The Committee on Assessing Improvements in Cancer Care in Georgia wishes to acknowledge the many people whose time and contributions made this report possible.

Agency for Healthcare Research and Quality

Ed Kelley

American Cancer Society

Michael Thun

American Society for Clinical Oncology

Jennifer Padberg

Brown University

Joan Teno

Centers for Disease Control and Prevention

Lesley Given

Amy Harris

Nancy Lee

Fred Stallings

DeKalb Surgical Associates

John Kennedy

Emory University Health Sciences Center and Rollins School of Public Health

Otis Brawley

Jim Curran

Michael Johns

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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Jonathan Liff

Jack Mandel

Jonathan W. Simons

John L. Young

Georgia Cancer Coalition

Kate Canterbury

Maryalice Moses

Nancy Paris

Kathy Russell

Russell Toal

Bill Todd

Georgia Division of Public Health

Rana Bayakly

James Brannon

Dafna Kanny

Linda Martin

Christy McNamara

Kim Redding

Georgia Health Policy Center

Karen Minyard

Georgia Medical Care Foundation

Bill McClellan

Tom W. Williams

Georgia Society of Clinical Oncology

Tom Andrews

Charles Henderson

Frederick M. Schnell

Harvard School of Public Health

Heather Palmer

Institute for Clinical Systems Improvement

Gordon Mosser

Joint Commission on Accreditation of Healthcare Organizations

Elvira Ryan

Marin General Hospital

Lloyd Miyawaki

Miami University of Ohio

John Bailer

Morehouse School of Medicine

Daniel Blumenthal

Nigel Harris

George Rust

Louis Sullivan

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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National Cancer Institute

Neeraj Arora

Molla Donaldson

National Committee for Quality Assurance

Greg Pawlson

Phil Renner

National Quality Forum

Kenneth Kizer

Elaine Power

Northwest Crescent

Debbie Davis

Diane Stapleton

Promina Health System

Betty Castellani

Jeff Etchason

Andrew Morley, Jr.

Southeast Georgia Alliance

W. Kent Guion

J. Ted Holloway

William Hoskins

Southwest Georgia Alliance

Angela Prince

Rita Salain

University of Southern California

David Quinn

University of Wisconsin

June Dahl

Woodruff Foundation

Charles McTier

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 Key Methods,

 

30

   

 Guiding Principles and Criteria Used to Select Quality Measures of Cancer Care,

 

30

   

 Consideration of Levels of Evidence for Quality-of-Cancer-Care Measures,

 

32

   

 Focus on Clinical Indicators of the Quality of Cancer Care,

 

33

   

 Focus on Four Common Cancers in Adults,

 

34

   

 Expert Panel Process,

 

34

   

 Sources of Quality-of-Cancer-Care Measures Considered,

 

36

   

 Data for Recommended Quality-of-Cancer-Care Measures in Georgia,

 

36

   

 Cancer Registries,

 

38

   

 Medical Records,

 

44

   

 Administrative Claims,

 

45

   

 Patient and Population Surveys,

 

46

   

 Issues in Interpreting Quality-of-Cancer-Care Data,

 

48

   

 Summary,

 

49

3

 

PREVENTING CANCER

 

54

   

 Recommended Measures for Tracking the Quality of Cancer Prevention,

 

56

   

 Smoking Rates and Interventions,

 

56

   

 Trend in Obesity,

 

58

   

 Cancer Incidence Rates,

 

60

   

 Data Sources,

 

62

   

 Summary,

 

62

   

 Quality Measure Specifications: Preventing Cancer,

 

64

4

 

DETECTING CANCER EARLY

 

79

   

 Recommended Measures for Tracking the Quality of Early Cancer Detection,

 

81

   

 Use of Cancer Screening Interventions,

 

81

   

 Cancer Stage at Diagnosis,

 

88

   

 Data Sources,

 

92

   

 Summary,

 

92

   

 Quality Measure Specifications: Detecting Cancer Early,

 

94

5

 

DIAGNOSING CANCER

 

108

   

 Recommended Measures for Tracking the Quality of Cancer Diagnosis,

 

110

   

 Adequacy of Cancer Diagnostic and Surgical Specimens,

 

110

   

 Adequacy of Pathology Reporting on Cancer Surgical Specimens,

 

116

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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 Documentation of Cancer Pathologic Stage Before Chemotherapy or Radiation Treatment Begins,

 

123

   

 Data Sources,

 

125

   

 Summary,

 

125

   

 Quality Measure Specifications: Diagnosing Cancer,

 

127

6

 

TREATING CANCER

 

160

   

 Recommended Measures for Tracking the Quality of Cancer Treatment,

 

162

   

 Receipt of Appropriate Primary Therapy for Cancer,

 

162

   

 Receipt of Appropriate Adjuvant Therapy for Cancer,

 

168

   

 Receipt of Appropriate Follow-Up After Treatment for Cancer,

 

172

   

 Minimization of Cancer Patients’ Suffering,

 

174

   

 Cancer Survival and Mortality Rates,

 

177

   

 Data Sources,

 

181

   

 Summary,

 

181

   

 Quality Measure Specifications: Treating Cancer,

 

183

7

 

CROSSCUTTING ISSUES IN ASSESSING THE QUALITY OF CANCER CARE

 

223

   

 Capturing Cancer Patients’ Experiences,

 

223

   

 Designing Surveys of Cancer Patients,

 

224

   

 Potential Topics for Cancer Patient Surveys,

 

228

   

 Evaluating Disparities in Cancer Care,

 

230

   

 What Causes Disparities in Health and Health Care?,

 

230

   

 Data Infrastructure Needed to Reduce Cancer Disparities,

 

230

   

 Summary,

 

236

8

 

LOOKING AHEAD TO THE IMPLEMENTATION OF QUALITY-OF-CANCER-CARE MEASURES

 

241

   

1  The use of quality-of-cancer-care measures has a dual purpose: evaluating progress and motivating change,

 

242

   

2  GCC should develop a cancer surveillance, monitoring, and evaluation plan that incorporates a strategy for promotion and dissemination,

 

242

   

3  Georgia’s quality-of-cancer-care monitoring system should be transparent and very public,

 

243

   

4  Monitoring of the quality-of-cancer-care indicators should be managed by the highest level of GCC,

 

244

   

5  GCC’s quality-of-cancer-care infrastructure should build on Georgia’s existing measurement and reporting systems,

 

244

   

6  Credibility of the system will be paramount: collect, interpret, and present the results carefully,

 

245

   

 Summary,

 

245

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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List of Boxes, Figures, and Tables

Executive Summary

Table

ES-1

 

Recommended Quality Measures for Tracking Georgia’s Progress in Cancer Control,

 

5

Chapter 2

Boxes

2-1

 

Strategic Goals of the Georgia Cancer Coalition,

 

31

2-2

 

Levels of Evidence Applied to Clinical Research,

 

33

2-3

 

Principal Sources of Candidate Quality-of-Cancer-Care Measures Considered by the IOM Committee,

 

37

Figures

2-1

 

Domains of the cancer control continuum with selected examples of activities in each domain,

 

28

2-2

 

Sample scoring sheet used to evaluate potential quality measures,

 

29

2-3

 

Sample calculation of a quality-of-cancer-care measure (breast cancer screening),

 

49

Tables

2-1

 

Incidence and Mortality in Georgia from the Four Most Common Cancers, 2000,

 

34

2-2

 

Potential Sources of Data for Quality-of-Cancer-Care Measures and Benchmarks,

 

39

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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2-3

 

Strengths and Weaknesses of Key Sources of Data for Quality-of-Cancer-Care Measures and Benchmarks,

 

40

Chapter 3

Box

3-1

 

Recommended Measures for Tracking the Quality of Cancer Prevention,

 

55

Figure

3-1

 

Obesity by body mass index, Georgia, 1990-2002,

 

60

Tables

3-1

 

Cigarette Smoking by Adults and Adolescents in Georgia,

 

58

3-2

 

Incidence of the Four Leading Cancers in Georgia, by Sex, 2000,

 

61

3-3

 

Potential Data Sources for Recommended Measures of the Quality of Cancer Prevention in Georgia,

 

63

Chapter 4

Boxes

4-1

 

Recommended Measures for Tracking the Quality of Early Cancer Detection,

 

80

4-2

 

Colorectal Cancer Screening Procedures and Recommended Frequency,

 

86

4-3

 

The SEER Summary Staging System for Cancer,

 

89

Figures

4-1

 

Breast cancer incidence and mortality in Georgia, by age group, 1997-2001,

 

83

4-2

 

Incidence of colorectal cancer by age at diagnosis and sex, United States, 1997-2001,

 

85

4-3

 

Percentage of adults aged 50 and older in Georgia who ever had a colonoscopy or sigmoidoscopy, by sex, 1993-2002,

 

87

Tables

4-1

 

Breast Cancer Screening Rate Among Women over Age 40 in Georgia, by Income and Access to Medical Care, 2002,

 

84

4-2

 

Colorectal Cancer Screening Rate Among Adults over Age 50 in Georgia, by Age and Access to Medical Care, 2001,

 

87

4-3

 

Survival of Breast Cancer and Colorectal Cancer in the United States, by Stage at Diagnosis, 1995-2000,

 

88

4-4

 

Early- and Advanced-Stage Breast and Colorectal Cancers at Diagnosis in Georgia as a Percentage of Total Cases, 1999-2000,

 

90

4-5

 

Incidence of Advanced-Stage Breast and Colorectal Cancers, by Age, in the United States, 2000,

 

91

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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4-6

 

Potential Data Sources for Recommended Measures of the Quality of Cancer Early Detection in Georgia,

 

93

Chapter 5

Boxes

5-1

 

Recommended Measures for Tracking the Quality of Cancer Diagnosis,

 

109

5-2

 

The Breast Imaging and Reporting Data System (BI-RADS),

 

112

5-3

 

NM Stages of Breast Cancer,

 

115

Figure

5-1

 

Pathology report checklist for a prostate cancer surgical specimen, College of American Pathologists,

 

118

Tables

5-1

 

Cancer Programs in Georgia That Are Certified by the Commission on Cancer,

 

122

5-2

 

Potential Data Sources for Recommended Measures of the Quality of Cancer Diagnosis in Georgia,

 

126

Chapter 6

Boxes

6-1

 

Recommended Measures for Tracking the Quality of Cancer Treatment,

 

161

6-2

 

Determining the Risk of Recurrence in Prostate Cancer Patients,

 

165

6-3

 

Caveat Emptor: Interpreting Cancer Survival Statistics,

 

179

Figures

6-1

 

Mortality rate for each of four leading cancers in Georgia, 1994-2002,

 

180

6-2

 

Mortality rate for all cancers in Georgia, 1994-2002,

 

180

Tables

6-1

 

Relative Survival Rates for Breast, Colorectal, Lung and Bronchus, and Prostate Cancers,

 

178

6-2

 

Potential Data Sources for Recommended Measures of the Quality of Cancer Treatment in Georgia,

 

182

Chapter 7

Boxes

7-1

 

Rapidly Changing Demographics in Georgia,

 

232

7-2

 

Standardizing Racial and Ethnic Categories for Public Policy Uses,

 

234

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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Tables

7-1

 

Examples of Survey Instruments That Measure the Patient Experience and Quality of Life,

 

225

7-2

 

Potential Domains and Topics for Cancer Patient Surveys,

 

229

7-3

 

Incidence and Mortality Rates for Four Leading Cancers in Georgia, by Gender, Race, and Ethnicity, 2001,

 

231

7-4

 

Percentage of Nonelderly Persons in Georgia Who Are Uninsured, by Race and Ethnicity, 2002-2003,

 

233

7-5

 

Percentage of Persons in Georgia Who Are Living in Poverty, by Race and Ethnicity, 2002-2003,

 

233

Chapter 8

Figure

8-1

 

Schematic of the Georgia Cancer Coalition’s Quality Monitoring, Surveillance, and Evaluation Unit,

 

243

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2005. Assessing the Quality of Cancer Care: An Approach to Measurement in Georgia. Washington, DC: The National Academies Press. doi: 10.17226/11244.
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Shortly after 1998, leading members of Georgia's government, medical community, and public-spirited citizenry began considering ways in which some of Georgia's almost $5 billion, 25-year settlement from the tobacco industry's Master Settlement Agreement with the 50 states could be used to benefit Georgia residents. Given tobacco's role in causing cancer, they decided to create an entity and program with the mission of making Georgia a national leader in cancer prevention, treatment, and research. This new entity--called the Georgia Cancer Coalition, Inc. (GCC)-- and the state of Georgia subsequently began implementing a far-reaching state cancer initiative that includes five strategic goals: (1) preventing cancer and detecting existing cancers earlier; (2) improving access to quality care for all state residents with cancer; (3) saving more lives in the future; (4) training future cancer researchers and caregivers; and (5) turning the eradication of cancer into economic growth for Georgia.

Assessing the Quality of Cancer Care identifies a set of measures that could be used to gauge Georgia's progress in improving the quality of its cancer services and in reducing cancer-related morbidity and mortality.

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