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cancer treatment could begin to outpace health care inflation as a whole (Sullivan et al., 2011).

Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates (Eheman et al., 2012). Compared to other OECD countries, the United States has a lower cancer mortality rate for males and a similar cancer mortality rate for females (OECD, 2013). However, many indications suggest that cancer care is not optimal. Despite progress in reducing cancer death rates, disparities in cancer outcomes persist, problems of overuse and misuse contribute to a lack of evidence-based cancer screening and treatment, and many patients do not experience patient-centered cancer care, such as access to palliative care and use of treatment plans to help with patient–clinician communication and decision making (Goodwin et al., 2011; IOM, 2011; Schnipper et al., 2012; Siegel et al., 2011). In addition, there are missed opportunities to collect information that could help inform clinical practice decision making (IOM, 2012a), as electronic medical records (EMRs) are often not designed for this purpose.

With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine’s (IOM’s) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8–9, 2012, in Washington, DC.1 Workshop presentations and discussions examined the drivers of current and projected cancer care costs, including

  • inappropriate financial incentives in the health care system;
  • unrealistic expectations about the effectiveness of screening and treatments for cancer by both patients and clinicians;
  • overuse and misuse of medical resources and inadequate adherence with treatment guidelines; and
  • lack of evidence on what represents high-quality, affordable cancer care.


1This workshop was organized by an independent planning committee whose role was limited to the identification of topics and speakers. This workshop summary was prepared by the rapporteurs as a factual summary of the presentations and discussions that took place at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, are not necessarily endorsed or verified by the Institute of Medicine or the National Cancer Policy Forum, and should not be construed as reflecting any group consensus.

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