promote measurement of aspects of care of particular relevance to individuals with cancer and disseminate information to raise awareness of quality issues. The National Coalition for Cancer Survivorship has, for example, published "principles of excellence" in cancer care (Box 6.2).

BOX 6.2 National Coalition for Cancer Survivorship: Imperatives for Quality Cancer Care

Principle 1

People with cancer have the right to a system of universal health care. This access should not be precluded because of preexisting conditions, genetic or other risk factors, or employment status.

Principle 2

Quality cancer care should be available in a health care system whose standards and guidelines are developed in consideration of treating the whole person with cancer. Health care plans must regard the cancer patient as an autonomous individual who has the right to be involved in decisions about his or her care.

Principle 3

Standards of cancer care should be driven by the quality of care, not only by the cost of care, and should include participation in clinical trials and quality-of-life considerations.

Principle 4

All people diagnosed with cancer should have access to and coverage for services provided by a multidisciplinary team of care providers across the full continuum of care. Health care plans should be held accountable for timely referral to appropriate specialists when symptoms of cancer or its recurrence may be present.

Principle 5

People with cancer should be provided a range of benefits by all health care plans that include primary and secondary prevention; early detection; initial treatment; supportive therapies to manage pain, nausea, fatigue, and infections; long-term follow-up; psychosocial services; palliative care; hospice care; and bereavement counseling.

Principle 6

People with histories of cancer have the right to continued medical follow-up with basic standards of care that include the specific needs of long-term survivors.



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