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Index
A
Access to care, general, 1, 2, 11, 15, 46-67, 144, 146, 181, 182, 213, 214, 220
coordination of care, 2, 7, 26, 30, 40-41, 46, 133, 175, 214, 215, 220
federal, 2, 19, 41, 145, 175
defined, 46
educational attainment, 11, 47, 53, 61, 134, 148
fee-for-service care, 37, 39, 40, 43, 99, 116, 117, 133-137, 138, 152
financial barriers, general, 7-8, 15-16, 47, 55;
see also Costs
geographic barriers, 11, 46, 224
HEDIS, 157
nonfinancial barriers, 11, 46, 47, 52, 54-59, 64-65, 66, 205, 215, 224;
see also Attitudes and beliefs;
Cultural factors
referral to care, 38, 39, 96, 146, 151, 224
utilization reviews, 38
see also Demographic factors;
Health insurance;
Managed care;
Socioeconomic
status
Accountability, 6, 15, 18, 39-40, 67, 144-145, 154, 158, 175, 212, 218-219
see also Standards
Accreditation/approval, organizations, 6, 30-31, 39, 81, 146-147, 148, 151-152, 155-164, 174, 219
insurers, 6, 39, 151-52, 174, 175, 219
Adjuvant therapy, 22-23, 61, 82, 153
breast cancer, 94-95, 98, 99, 101-102, 108, 109, 153, 171, 173
colorectal cancer, 173
Advisory Board Company, 165
Advisory Commission on Consumer Protection and Quality in the Health Care Industry, 5, 145, 175
African Americans, 20, 191, 192, 194, 200, 202-203
hospitalizations, 33
incidence, 20, 21
screening, 51, 53, 54-55, 58, 62, 189, 198
survival rates, 20, 21, 47
treatment, 59, 62, 63, 205
Age factors, 20, 31, 33, 89
breast cancer, 54, 91, 99-101, 167
clinical trials, 62, 63
cost of care and, 36
insurance coverage, 117
mammography, 54, 91, 167
prostate cancer, 103, 105, 202
treatment, general, 60-61, 62, 99-101, 120
see also Children;
Elderly persons
Agency for Health Care Policy and Research, 8, 19, 153, 154-155, 170, 175, 180, 185, 193-196, 209
Alternative treatments, 24, 204
Ambulatory care, 9, 10, 27-32, 163
American Accreditation Health Care Commission, Inc./URAC, 158
American Association of Health Plans, 154-155
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American Board of Internal Medicine, 26
American Board of Obstetrics and Gynecology, 26
American Board of Pediatrics, 26
American Board of Radiology, 26, 90
American Cancer Society, 49, 104, 203-206
consumer information, 148
National Cancer Data Base, 9, 89-90, 109, 124, 160, 222
American College of Radiology, 90, 106-107
American College of Surgeons, 6, 30-31, 147, 155, 158, 160, 174, 203
National Cancer Data Base, 9, 124
American Indians, see Native Americans
American Joint Committee on Cancer, 160
American Medical Association, 26
American Pain Society, 153
American Society of Clinical Oncology, 26, 166-167
American Urological Association, 90, 104, 105, 106, 166, 179-171
Approaching Death: Improving Care at the End of Life, 65, 67
Asians, 54, 190, 206
Association of Community Cancer Centers, 160-163
Attitudes and beliefs
patient, 2, 11, 13, 14, 23, 46, 47, 62, 64, 65, 79, 85-86, 153, 157, 159
fatalism, 11, 53
physician, 54, 55, 59, 60, 63, 85
public opinion, 1, 2, 13, 14, 150;
see also Mass media
screening, 53, 54
see also Cultural factors; Public opinion
B
Beliefs, see Attitudes and beliefs
Bing Foundation, 108
Biopsies, 92-93, 156
Bladder cancer, 61, 88
Bone and bone marrow, 23, 59, 60, 127, 190, 203
see also Leukemia
Breast cancer, 3, 10, 11, 53, 91-103, 108-109, 151, 156, 159, 187, 189-190, 192, 193, 198, 203, 216
adjuvant therapy, 94-95, 98, 99, 101-102, 108, 109, 153, 171, 173
age factors, 54, 91, 99-101, 167;
see also ''elderly persons'' infra
chemotherapy, 60, 82, 94-95, 96, 98-99, 109, 129, 167, 171, 173, 174
clinical practice guidelines, 99, 165, 166, 167, 169, 171, 173, 174
cost of, 36
DoD program, 199-200, 201
elderly persons, 14, 42, 51, 54, 99-101, 134-135, 194, 196
mammography, 14, 42, 51, 54, 192, 197
incidence, 20, 91, 157
outcome analysis, 109, 126, 152, 185-186, 194;
see also "survivorship" infra
radiation therapy, 97, 98, 100, 101, 102, 108, 134, 159, 171, 173, 174
research funding, 8, 10, 185, 186, 187, 199
screening, 3, 14, 22, 42, 50-57 (passim), 83, 87, 91-94, 156, 167, 185-186, 189, 198, 200, 201, 205, 216, 224;
see also Mammography SEER, 60, 100, 108-109, 186
specialty care, 128, 129-130
standards, 3, 92, 102, 167, 173
surgery, 14, 59, 88, 94, 95-102, 109, 126, 129, 133-135, 153, 159, 160, 165, 173, 189, 204, 217
survivorship, 46, 88, 94, 126, 128, 129, 133, 134-136, 159
treatment, 3, 14, 23, 27, 28, 30, 31, 42, 46, 58, 59, 60-62, 82, 92, 94-103, 126, 108, 109, 126, 128, 129-130, 132, 133, 134-136, 153, 156, 159, 186, 189, 200, 201;
see also "chemotherapy," "clinical practice guidelines," and "radiation therapy" supra
Breast Cancer Surveillance Consortium, 185-186
Bronchial cancer
incidence, 20
survival rates, 47
treatment, 30
C
Canada, 51, 129, 130, 132-133, 171
Cancer at the Crossroads, 13
Cancer Care, 49
Cancer care centers, 18, 19, 34, 90, 146-147, 160-163, 165, 171
National Comprehensive Cancer Network, 90, 165, 166, 167
Cancer registries, 89, 90, 98, 100, 117, 136, 153, 154, 161, 185, 194, 203
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Counseling, see Patient education and counseling; Psychosocial impacts and support
Cultural factors, 14, 16, 24, 46, 47, 53, 66, 79
see also Language factors
D
Databases, 8-9, 57, 138-139, 152, 221
CONQUEST, 194
consumer education, 148
HEDIS, 152, 154, 156-158
insurance, 9, 98, 152, 154, 156-158
NLM/HSRProj, 181-183, 184, 192, 197, 206
screening, 57, 157
see also Cancer registries
Data collection and surveillance, 88-90, 138-139, 154, 180-209, 213 , 220-223
breast and colorectal cancer, 166
funding, 8, 10, 18
HCFA, 152, 197
national studies, 10
patient records, 3, 88-89, 98, 101, 117, 123-124, 125, 160, 212
posttreatment surveillance, 25, 63, 203
recommendations, 8-9
see also Cancer registries;
Clinical trials;
Monitoring and reporting;
National Cancer Data Base;
Surveillance, Epidemiology, and End Results
program
Decision making, 148, 201, 220
consumer information, 146-148;
see also Public education
patient-centered care, 23, 79, 165, 194
public policy, 80
treatment options, 2, 3, 6-7, 59, 62, 80, 83, 105-106, 170-171, 175 , 220
Demographic factors, 11, 47
data collection practices, 9, 90
rural areas, 4, 54, 56, 58, 129, 198, 212, 216
urban areas, 4, 54, 58, 93, 129, 134, 135, 136, 198, 212, 216
see also Age factors;
Educational attainment;
Gender differences;
Geographic factors;
Minority groups;
Poverty;
Socioeconomic status
Department of Defense, 180, 199-202
Department of Health and Human Services, 184-199
see also National Cancer Institute;
other specific agencies and offices
Department of Veterans Affairs, 104, 125, 180, 202-203
Depression, 64-65
Diagnoses, 2, 15, 19, 20, 22, 41, 79, 154
biopsies, 92-93, 156
guidelines, 4-5
HEDIS, 157
insurance, 41, 48
late-stage cancers, 8, 51, 117-118, 128
lung cancer, 117
national statistics, 13
see also Screening
Diet and nutrition, 24, 162
Documented Outcomes Collection System, 90
Drugs
end-of-life care, 64
insurance coverage, 10, 43, 49, 50, 66, 223-224
Medicare coverage, 50, 66
prostate cancer, 107
standards, 162, 164, 168
see also Chemotherapy;
Hormone therapy;
Pain and pain management
E
Economic factors, 13-14, 15, 116, 181, 182
fee-for-service care, 37, 39, 40, 43, 99, 116, 117, 133-137, 138, 151-152
loss of earnings, 20, 35
market forces, general, 145, 150-151
screening incentives, 55, 56
see also Costs;
Health insurance;
Poverty;
Socioeconomic status
Education, see Patient education and counseling: Professional education; Public education
Educational attainment, 11, 47, 53, 61, 134, 148
Elderly persons, 224, 225
breast cancer, 14, 42, 51, 54, 99-101, 134-135, 194, 196
mammography, 14, 42, 51, 54, 192, 197
clinical trials, 62
colorectal cancer, 51, 153
educational interventions, 191
incidence, 20, 37, 145-146
pain management, 47, 64, 191
prostate cancer, 103, 152, 153
screening, 54;
see also "breast cancer-mammography" supra
SEER, 186
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treatment, 11-12, 30, 31, 32, 33, 59, 60-61, 62, 66, 99-101, 121, 128, 136, 152, 196
see also Medicare
Emotional support, see Psychosocial impacts and support
Employee Retirement Income Security Act, 39-40, 41
End-of-life care, 25-26, 33, 63-66, 67, 191, 193, 194, 213, 220
chemotherapy, 167
hospice care, 65, 149, 152, 163, 197
Medicare, 64
patient education, 25-26, 64-65
England, 129, 130, 133
Esophageal cancer, 4, 121, 122
Ethnicity, see Minority groups
F
Federal government, general, 16, 18-19, 144, 151
clinical trials, funding, 8
coordination of agencies, 19, 145
coordination of care, 2, 19, 41, 175
research sponsorship, 180, 184-203
see also Legislation, federal;
specific departments and agencies
Fee-for-service care, 37, 39, 40, 43, 99, 116, 117, 133-137, 138, 151-152
see also Medicare
Food and Drug Administration, 92
Foreign countries, see International perspectives; specific countries
Foundation for Accountability, 146, 158, 159
France, 171-172, 174
Funding
breast cancer research, 8, 10, 185, 186, 187, 199
research, other, 8, 18, 180, 181, 185, 187, 193, 197, 200, 202, 203 , 205, 209
G
Gender differences
incidence, 20
physician attitudes toward screening, 55
treatment, 61, 135
see also Men;
Women
General Accounting Office, 81-82
Geographic factors, 14
as access barrier, 11, 46, 224
insurance, 197
screening, 136, 152
SEER, 9, 89, 222
survivorship, 118
treatment, 58-59, 62, 95-96, 133, 136, 204
see also Regional factors;
Rural areas;
Urban areas
Guidelines, see Clinical practice guidelines
H
Health Care Financing Administration, 6, 19, 39, 146, 151-154, 175 , 185, 196-197, 209, 219
SEER-Medicare data, 9, 89, 108, 121, 123, 134, 138, 185, 186, 196
Health Care Quality Improvement Program, 152
Health insurance, 1, 6-7, 14, 15, 18, 32, 47, 117, 133-137, 146, 149
accountability, 144
accreditation, 6, 39, 151-152, 174, 175, 219
age factors, 117
colorectal cancer, 42, 136
complaints and appeals, 39-40
costs to individuals
out-of-pocket, 50, 52, 57, 59, 64, 66
premiums, 47, 48, 50, 52
databases, 9, 98, 152, 154, 156-158
disease management specialists, 40-41, 133
drugs, 10, 43, 49, 50, 66, 223-224
chemotherapy, 50, 59
HMOs, 35, 36, 37, 38, 39, 54, 57, 117, 133-137, 138, 152, 186-187, 199
legislation, federal, 38, 48
legislation, state, 11, 39, 40, 41, 42-43
mammography, 42
preferred provider organizations, 152, 155, 158
standards, 175;
see also "accreditation" supra
treatment, 10, 41, 42, 43, 49, 50, 59, 66, 98, 99, 223-224
uninsured/underinsured persons, 10, 11, 13-14, 15, 35, 48-49, 66, 213, 223-224
see also Managed care;
Medicaid;
Medicare
Health Insurance Portability and Accountability Act, 48
Health Maintenance Organization Act, 38
Health maintenance organizations, 35, 36, 37, 38, 39, 54, 57, 117, 133-137, 138, 151-152, 186-187, 199
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Cancer Research Network, 186-187
Health Plan Employer Data Information Set (HEDIS), 152, 154, 156-158
Health services research, defined, 181
Healthy People 2000, 154
Hematopoietic growth factors, 169-170
Hill-Burton Act, 48
Hispanics, 47, 190, 191
screening, 53, 54-55
treatment, 59
HMO Cancer Research Network, 186-187
Hodgkin' s disease, 82, 129
Home care, 32, 163
Hormone therapy, 22, 23, 32, 60, 94-95, 98, 107, 174, 188
Hospice care, 65, 149, 152, 163, 197
Hospitals, 19, 30-34, 59, 118
approval/accreditation status, 6, 30-31, 146-147, 152, 155, 158, 219
breast cancer surgery, 42, 97, 101, 135
charity requirements, 48
clinical trials, 34
costs, 35
National Cancer Data Base, 89-90
pain management, 153
specialist, 128-130, 133
volume-outcome relationship, 4, 116, 118-128, 151, 212, 217
see also Cancer care centers;
Surgery
HSRProj, 184, 192, 197, 206
I
Immune system, 23
Incidence, 13, 20
African Americans, 20, 21
breast cancer, 20, 91, 157
by cancer site, 21-22
elderly persons, 20, 37, 145-146
Insurance, see Health insurance
Interdisciplinary approaches, 26, 36, 61, 65, 119, 130, 139, 149, 161, 162, 167
continuous quality improvement programs, 163-164
patient education, 26, 30, 65
research, 180, 181
see also Specialists and specialist care
International Bone Marrow Transplant Registry, 127
International perspectives, 126-128
chemotherapy, 171-172
clinical trials, 34
specialty care, 129
see also specific countries
Internet, 15 (footnote), 145, 146, 155, 158, 184, 185, 194, 197
Italy, 171, 173
J
Joint Commission on Accreditation of Healthcare Organizations, 146 , 155, 156, 160
L
Language factors, 11, 46, 47
Larnyx cancer, 27, 28
Legislation, federal, 18, 19, 39, 182
Employee Retirement Income Security Act, 39-40, 41
Health Insurance Portability and Accountability Act, 48
Health Maintenance Organization Act, 38
Hill-Burton Act, 48
Mammography Quality Standards Act, 186
National Cancer Act, 13, 18, 19, 89
National Institutes of Health Revitalization Act, 62-63, 165
Patient's Bill of Rights, 41
Legislation, state, 18, 19, 67, 182
insurance, 11, 39, 40, 41, 42-43
Leukemia, 4, 27, 28, 30, 61, 127-128, 190
Liver cancer, 102, 121, 122
Local factors, 2, 4, 166
Lung cancer, 4, 10, 156
chemotherapy, 166-167, 190
clinical practice guidelines, 166-167, 169, 172
incidence, 20
SEER, 185
survivorship, 47, 88, 117-118
treatment, 27, 28, 30, 31, 59, 60, 61, 82, 117-118, 119-122, 156, 166-167, 185, 190, 203
Lymphoma, 27, 28, 30, 31, 61, 82, 88
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M
Mammography, 3, 14, 22, 50-57 (passim), 83, 87, 91-92, 102, 108, 159, 167, 185-186, 189, 196, 198, 205, 216
age factors, 54, 91, 167
insurance, 42
standards, 3, 92, 102, 167, 173
Mammography Quality Standards Act, 186
Managed care, 6, 16, 36, 37-43, 116, 133-137, 138, 146, 144, 196
clinical practice guidelines, 172
clinical trials, 37, 41, 63
defined, 37, 38
HMOs, 35, 36, 37, 38, 39, 54, 57, 117, 133-137, 138, 152, 199, 186 -187
Medicare, 36, 37, 39, 134-135, 151-152
pain management, 193
preferred provider organizations, 152, 155, 158
screening, 40-41, 42, 52, 54
specialist care, 37-38, 40-41, 133
surgery, 38, 42
see also Employer-based plans
Market forces, 145, 150-151
Mass media, 147, 198
Internet, 15
(footnote), 145, 146, 155, 158, 184, 185, 194, 197
see also Public education
M.D. Anderson Cancer Center, 165
Measurement issues, 1, 2, 3, 5, 15, 16, 67, 80-88, 107-109, 116-139 , 145, 212, 215-216, 218-219
managed care vs fee-for-service care, 133-137
process quality, 80, 81-84, 94, 108, 116, 126, 128, 135, 152, 181
structural quality, 80, 80-81
see also Monitoring and reporting;
Outcome analysis
Medicaid, 6, 10, 34, 42, 43, 48, 52, 66, 99, 153, 197, 198, 212, 219
complaints and appeals, 39
Medical records, 3, 88-89, 98, 101, 117, 123-124, 125, 160, 212
Medicare, 2, 6, 10, 30, 34, 48, 52, 66, 99, 100, 136, 145-146, 175 , 196-197, 198, 212, 219
certification of providers, 151-153
complaints and appeals, 39
coverage options, 152
drug coverage, 50, 66
end-of-life care, 64
managed care, 36, 37, 39, 134-135, 151-152
out-of-pocket costs, 50, 64
SEER linked to, 9, 89, 108, 121, 123, 134, 138, 185, 186, 196-197
Medline, 181-183
Memorial Sloan-Kettering Cancer Center, 165
Men, 33, 58
incidence, 20
see also Prostate cancer
Minority groups, 11, 47, 190, 191, 198, 202, 224
Asians, 54, 190, 206
clinical trials, 34, 62-63
Hispanics, 47, 53, 54-55, 59, 190, 191
hospitalizations, 33
Native Americans, 47, 191, 198
pain management, 64
screening, 51, 53-55, 58, 62, 189, 190, 198
survival rates, 20, 21, 47
treatment, 59, 61, 62-63, 66, 205
see also African Americans
Monitoring and reporting, 2, 5, 6, 117-118, 215, 218, 220-223
see also Data collection and surveillance
Mortality rates, 4, 9, 86
breast cancer, 91
national statistics, 13
prostate cancer, 103
volume-outcome relationship, 4, 116, 118-128, 151, 212, 217
see also Survivorship
Multidisciplinary care, see Interdisciplinary approaches; Specialists and specialist care
N
National Ambulatory Medical Care Survey (NAMCS), 27, 30
National Cancer Act, 13, 18, 19, 89
National Cancer Advisory Board, 19
National Cancer Data Base, 9, 89-90, 109, 124, 160, 222
National Cancer Institute, 8, 18, 19, 34, 99, 104, 148, 185-192, 209
clinical trials, 34, 62, 99
funding, 185, 186
Office of Cancer Survivorship, 187-188
see also Surveillance, Epidemiology, and End Results program
National Cancer Policy Board, 65-66, 180, 181, 184, 211, 214-215, 216
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National Cancer Program, 19
National Center for Chronic Disease Prevention and Health, 198-199
National Center for Health Statistics, 27, 199
National Coalition of Cancer Survivors, 149
National Committee for Quality Assurance, 6, 146
HEDIS, 152, 154, 156-158
National Comprehensive Cancer Network, 90, 165, 166, 167
National Hospital Ambulatory Medical Care Survey (NHAMCS), 27, 30
National Institute of Dental Research, 192
National Institute on Aging, 192
National Institutes of Health, 185-192
see also National Cancer Institute
National Institutes of Health Revitalization Act, 62-63
National Library of Medicine, 181, 192
Native Americans, 47, 191, 198
Nontraditional treatments, see Alternative treatments
Norway, 130
Nurses and nursing, 26, 30, 162, 200, 204
Nutrition, see Diet and nutrition
O
Office of Cancer Survivorship, 187-188
Organ Transplant Fund, 49
Outcome analysis, 9, 10, 40, 66, 80, 81, 84-87, 90, 116, 117, 154, 181, 194, 205
breast cancer, 109, 126, 152, 185-186, 194
funding, 185
process and, 83-84, 116, 130
prostate cancer, 104, 105, 106, 109, 125, 185, 194, 200, 205
specialist care, 128-133, 137-138
survival rates in, 84-85, 86, 88, 117-118, 122-133
volume-outcome relationship, 4, 116, 118-128, 137, 151, 212, 217
see also Survivorship
Outcomes and Assessment Information Set (OASIS), 152
Outpatient care, see Ambulatory care
Ovarian cancer, 88, 128, 130-131, 171, 172, 174, 200
P
Pacific Business Group on Health, 151
Pain and pain management, 7-8, 10, 24, 25, 30, 64, 67, 149, 153, 190, 191, 194
American Pain Society, 153
attitudes toward pain, 53
clinical guidelines, 4-5, 165, 170
elderly persons, 47, 64, 191
managed care, 193
prostate cancer, 107
socioeconomic status, 47
standards, 4-5, 153, 163, 165
Palliative care, see Pain and pain management
Pancreatic cancer, 4, 119, 121, 122, 124-125, 128-129, 190
Pap smears, 22, 51, 54-55, 56, 57, 190
Patient education and counseling, 23, 30, 105, 148, 149, 150, 153, 182, 188
clinical practice guidelines, 165, 168, 173
diagnosis, 2
end-of-life care, 25-26, 64-65
insurance coverage, 55
interdisciplinary, 26, 30, 65
screening, 55, 57
side-effects, 59
standards, 161, 162, 165, 168, 173
telephone services, 57, 148, 205
treatment options, 2, 3, 6-7, 59, 62, 80, 83, 105-106, 170-171, 175 , 220
see also Psychosocial impacts and support
Patient Outcomes Research Teams, 194
Patterns of Care studies, 90, 185, 192, 204
Peer review organizations, 152, 153
Pharmaceuticals, see Chemotherapy; Drugs; Hormone therapy
Physician Data Query system, 148
Physicians, 14, 18, 26, 27, 31, 130-133, 138, 146, 197, 204
access to, 54-55
accountability, 6, 40
ambulatory care, 27-30
attitudes and beliefs of, 54, 55, 59, 60, 63, 85
board certification, 6, 26, 219
clinical trials, 34
costs associated with, 35
elderly patients, 54, 60
managed care and, 38, 40
performance assessment, 83
referral to specialists, 38
screening variables, 54, 55, 56, 66
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specialty care, 130-133, 138, 146
treatment variables, 59, 60, 61-62
volume-outcome relationship, 118
Poverty, 66, 190, 224
cervical cancer, 51, 224
end-of-life care, 64
screening, 19, 43, 49, 51, 53, 56, 224
survival rates, 47
treatment, 43, 59
uninsured/underinsured, 10, 11, 13-14, 15, 35, 48-49, 66, 213, 223-224
Preferred provider organizations, 152, 155, 158
Preventive interventions, 11, 15, 87, 90-91, 134, 149, 154, 188, 189, 190-191, 193
guidelines, 4-5, 162
NCI, 19
smoking, 87, 187
see also Screening
Preventive Services Task Force, 104, 195
Private sector, general, 15, 16, 144, 175, 203-209, 218
clinical practice guidelines, 165
clinical trials, 8, 213
market forces, 145, 150-151
public-sector collaboration, 5, 175, 212, 218
research sponsorship, 180
see also Health insurance;
specific organizations
Professional education, 2, 9, 182, 212
end-of-life care, 67
health services research, 10
lack of appropriate, 47
screening, 56
standards, 161, 162, 168
see also Clinical practice guidelines
Prostate cancer, 4, 88, 103-109, 125, 194, 198-199, 200-201, 202-203, 205-206
age factors, 103, 105, 202
American Urological Association, 90, 104, 105, 106, 166, 179-171
chemotherapy, 107
clinical practice guidelines, 165, 170-171, 172
cost of, 36, 201
elderly persons, 103, 152, 153
incidence, 20, 103
insurance, 42, 136
radiation therapy, 105-107, 170-171
screening, 22, 42, 103, 104-105, 186, 190, 193, 198-199, 200, 201, 202
surgery, 103, 105, 106, 107, 125, 152, 153, 170-171, 204, 217
survivorship, 104, 105, 107, 108
treatment, 27, 28, 30, 31, 61, 103-108, 125, 170-171, 186, 190, 199, 200
Prostate Cancer Intervention Versus Observation Trial, 103
Prostate, Lung, Colorectal, and Ovarian screening trial, 103
Psychosocial impacts and support, 7, 25-26, 30, 149, 150, 153, 163, 187, 188, 190, 198, 200, 201, 205, 206, 220
end-of-life care, 64-66
pastoral care, 162
see also Decision making
Public education, 34, 57, 146-150, 151, 158, 182, 198, 212, 220
Internet, 15 (footnote), 145, 146, 155, 158, 184, 185, 194, 197
mass media, 147, 198
standards, 161
Public opinion, 1, 2, 13, 14, 150
see also Mass media
Put Prevention into Practice, 195
Q
Quality Interagency Coordination Health Care Task Force, 145
Quality of care, defined, 79, 116, 211-213, 215-216
R
Race/ethnicity, see Minority groups
Radiation therapy, 3, 22, 23, 61, 62, 83, 88, 90, 128
American College of Radiology, 90, 106-107
attitudes toward, 53
breast cancer, 97, 98, 100, 101, 102, 108, 134, 135, 159, 171, 173, 174
insurance coverage, 59
prostate cancer, 105-107, 170-171
specialist certification, 26
RAND, 108
Recurrent cancers, 8, 25, 104, 188
Rectal cancer, see Colorectal cancer
Referral to care, 38, 39, 96, 146, 151, 224
Regional factors, 2, 62, 116
breast cancer, 95, 97
Medicare reporting, 6
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see also Geographic factors;
Rural areas;
Urban areas
Reporting systems, see Data collection and surveillance; Monitoring and reporting
Reproductive effects, see Sexual and reproductive effects
Research Data Assistance Center, 197
Road to Recovery, 49
Rural areas, 4, 54, 56, 58, 129, 191, 198, 212, 216
S
Scotland, 126-127, 130, 132, 172
Screening, 3, 5, 11, 22, 48-49, 50-56, 90-91, 149, 154, 189, 190, 198
African Americans, 51, 53, 54-55, 58, 62, 189, 198
breast cancer, 3, 14, 22, 42, 50-57 (passim), 83, 87, 91-94, 156, 167, 185-186, 189, 198, 200, 201, 205, 216, 224;
see also Mammography
cervical cancer, 11, 14, 51, 185
colorectal cancer, 22, 42, 51, 54, 57, 58, 193, 198, 199, 203, 205
costs of, 50, 52, 57, 186, 189, 190
databases, 57, 157
follow-up, 5, 56-58, 91-94
geographic factors, 136, 152
HEDIS, 157
Hispanics, 53, 54-55
insurance coverage, 40-41, 42, 52
managed care, 40-41, 42, 52, 54
minority groups, 51, 53-55, 58, 62, 189, 190, 198
patient education, 55, 57
poor persons, 19, 43, 49, 51, 53, 56, 224
prostate cancer, 22, 42, 103, 104-105, 186, 190, 193, 198-199, 200, 201, 202
standards, 162, 167, 168
women, general, 51, 53, 55, 57, 190;
see also Mammography;
Pap smears
Sexual and reproductive effects, 188
Side-effects, 24, 59, 64, 187, 188, 225
prostate cancer, 103, 105-106
Skin cancer, 22, 27, 28, 30, 31, 192, 203
Smoking, 87, 187
women, 20
Social factors, see Cultural factors; Demographic factors; Psychosocial impacts and support; Socioeconomic status
Social Security Administration, 39
Society for Surgical Oncology, 166
Socioeconomic status, 14, 47, 48, 224
breast cancer survival, 136
educational attainment, 11, 47, 53, 61, 134, 148
end-of-life care, 64
prostate cancer, 198
treatment, 61, 66
see also Poverty
Specialists and specialist care, 16, 26-27, 55, 116, 128-133
ambulatory care, 27
breast cancer, 128, 129-130
certification, 26, 146
chemotherapy, 128, 129, 130, 131
diagnosis, 22
hospitals, 128-130, 133
insurance, disease management specialists, 40-41, 133
international perspectives, 129
managed care and, 37-38, 40-41, 133
surgery, 129, 130-133
survival rates and, 128-133
see also Interdisciplinary approaches
Standards, 2, 23, 37, 81, 102, 155, 214
accreditation/approval, 6, 30-31, 39, 81, 146-147, 148, 151-152, 155-164, 174, 219
insurers, 6, 39, 151-152, 174, 175, 219
ambulatory care, 163
breast cancer, 3, 92, 102, 167, 173
chemotherapy, 164
continuous quality improvement programs, 163-164
data collection, 154, 164, 175
diagnostic/screening, 154
drugs, 162, 164, 168
HEDIS, 157
hospital program approval, 6, 30-31
mammography, 3, 92, 102, 167, 173
National Coalition for Cancer Survivorship, 149-150
pain management, 4-5, 153, 163, 165
patient education, 161, 162, 165, 168, 173
professional education, 161, 162, 168
public education, 161
research, 13, 82, 83
screening, 162, 167, 168
specialist certification, 26
staging classification, 198
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survivorship, 161
see also Clinical practice guidelines
State-level actions, 144, 151, 154, 203
insurance, 11, 39, 40, 41, 42-43, 49
legislation, 18, 19, 67, 182
insurance, 11, 39, 40, 41, 42-43
National Cancer Data Base, 9, 89-90, 109, 124, 160, 222
peer review organizations, 152, 153
Supplemental Security Income, 48
Surgery, 22-23, 59, 61, 83, 88, 90, 190, 217
ambulatory care, postoperative, 30
American College of Surgeons, 6, 9, 30-31, 124, 147, 155, 158, 160, 174, 203
breast cancer, 14, 59, 88, 94, 95-102, 109, 126, 129, 133-135, 153, 159, 160, 165, 173, 189, 204, 217
clinical practice guidelines, 99, 133, 166, 167, 170-171, 172
high-risk, 4, 119-125, 217
managed care, 38, 42
ovarian cancer, 130-131
prostate cancer, 103, 105, 106, 107, 125, 152, 153, 170-171, 204, 217
specialty care, 129, 130-133
volume-outcome relationship, 4, 116, 118-128, 137, 151, 212, 217
see also American College of Surgeons
Surveillance, see Data collection and surveillance
Surveillance, Epidemiology, and End Results program, 9, 89, 90, 185, 186, 222
breast cancer, 60, 100, 108-109, 186
elderly persons, 186
geographic coverage, 9, 89, 222
incidence, by race, 21
Medicare linked to, 9, 89, 108, 121, 123, 134, 138, 185, 186, 196
overview and goals, 89
specialist care, 128, 129
survival rates, 21, 88
treatment, 9, 82, 185
Survivorship, 7, 117-118, 149-150, 187-188, 204
African Americans, 20, 21, 47
breast cancer, 46, 88, 94, 126, 128, 129, 133, 134-136, 159
costs and, 36-37
follow-up care, 8, 13, 25, 96, 102-103, 149-150
geographic factors, 118
insurance and, 48
length of, 9
lung cancer, 47, 88, 117-118
minority groups, 20, 21, 47
national statistics, 13
outcome measures, survival rates as, 84-85, 86, 88, 117-118, 122-133
patient overestimation, 65
process measures, 81-82, 116, 130
prostate cancer, 104, 105, 107, 108
rates, by cancer site, 88
rates, by race, 21
special care and, 128-133
standards, 161
see also End-of-life care;
Outcome analysis
Susan Komen Foundation, 187
Sweden, 130
T
Taking Action to Reduce Tobacco Use, 14
Tamoxifen, 94-95, 171
see also "chemotherapy" under Breast cancer
Telephone services, 57, 148, 205
Testicular cancer, 4, 126, 129, 130
Time-series studies, 82
Total quality management programs, see Continuous quality improvement programs
Transportation, 49
Treatment, 9, 13, 15, 18, 20, 22-26, 49, 58-63, 89, 138, 149, 167, 187, 189, 193-194
African Americans, 59, 62, 63, 205
age factors, 60-61, 62, 99-101, 120
alternative, 24, 204
appropriateness of, 2, 59, 81, 128
children, 34, 62
costs, general, 35, 186, 189, 190
decision making, treatment options, 2, 3, 6-7, 59, 62, 80, 83, 105-106, 170-171, 175, 220
elderly persons, 11-12, 30, 31, 32, 33, 59, 60-61, 62, 66, 99-101, 121, 128, 136, 152, 196
follow-up care, 8, 13, 25, 96, 102-103, 149-150
gender differences, 61, 135;
see also Women
geographic factors, 58-59, 62, 95-96, 133, 136, 204
Hispanics, 59
insurance coverage, 10, 41, 42, 43, 49, 50, 59, 66, 98, 99, 223-224
minorities, 59, 61, 62-63, 66, 205
physician variables, 59, 60, 61-62
posttreatment surveillance, 25, 63, 203
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recurrent/late-stage cancers, 8, 25
SEER, 9, 82, 185
women, general, 59, 60, 61, 62-63;
see also Breast cancer;
Cervical cancer;
Ovarian cancer
see also Adjuvant therapy;
Ambulatory care;
Clinical trials;
Drugs;
Interdisciplinary approaches;
Outcome analysis;
Pain and pain management;
Radiation therapy;
Side-effects;
Specialists and specialist care;
Surgery;
''treatment'' subheads under specific cancers/cancer sites
U
Unconventional treatments, see Alternative treatments
United Kingdom, 129, 130-131, 133, 182
Scotland, 126-127, 130, 132
Urban areas, 4, 54, 58, 93, 129, 134, 135, 136, 191, 198, 212, 216
Utilization reviews, 38, 46, 182
V
Volume-outcome relationship, 4, 116, 118-128, 137, 151, 212, 217
W
War on Cancer Act, see National Cancer Act
Women, 33
clinical trials, 62-63
colorectal cancer, 51
female physicians, 55
pain relief, 47
screening, general, 51, 53, 55, 57, 190;
see also Mammography;
Pap smears
smoking, 20
treatment, general, 59, 60, 61, 62-63
see also Breast cancer;
Cervical cancer;
Ovarian cancer
World Wide Web, see Internet
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