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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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DEVELOPING AND SUSTAINING
AN EFFECTIVE AND RESILIENT
ONCOLOGY CAREFORCE

PROCEEDINGS OF A WORKSHOP

Erin Balogh, Emily Zevon, Margie Patlak, and
Sharyl J. Nass, Rapporteurs

National Cancer Policy Forum

Board on Health Care Services

Health and Medicine Division

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THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by Contract No. 200-2011-38807 (Task Order No. 75D30118F00071) and Contract No. HHSN263201800029I (Task Order No. HHSN26300008) with the Centers for Disease Control and Prevention and the National Cancer Institute/National Institutes of Health, respectively, and by the American Association for Cancer Research, American Cancer Society, American College of Radiology, American Society of Clinical Oncology, Association of American Cancer Institutes, Association of Community Cancer Centers, Bristol-Myers Squibb, Cancer Support Community, CEO Roundtable on Cancer, Flatiron Health, Helsinn Therapeutics (U.S.), Inc., LIVESTRONG Foundation, Merck, National Comprehensive Cancer Network, Novartis Oncology, Oncology Nursing Society, and Pfizer Inc. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-49604-9
International Standard Book Number-10: 0-309-49604-7
Digital Object Identifier: https://doi.org/10.17226/25533

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2019 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2019. Developing and sustaining an effective and resilient oncology careforce: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25533.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
×

Image

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
×

WORKSHOP PLANNING COMMITTEE1

LISA KENNEDY SHELDON (Co-Chair), Chief Clinical Officer, Oncology Nursing Society

LAWRENCE N. SHULMAN (Co-Chair), Professor of Medicine, Deputy Director for Clinical Services, and Director, Center for Global Cancer Medicine, Abramson Cancer Center, University of Pennsylvania

AMY P. ABERNETHY, Chief Medical Officer, Chief Scientific Officer, and Senior Vice President, Oncology, Flatiron Health2

EDWARD J. BENZ, JR., President and Chief Executive Officer Emeritus, Dana-Farber Cancer Institute; Richard and Susan Smith Distinguished Professor of Medicine, Genetics and Pediatrics, Harvard Medical School

ROBERT W. CARLSON, Chief Executive Officer, National Comprehensive Cancer Network

CLESE ERIKSON, Deputy Director, Health Workforce Research Center, The George Washington University

STANTON L. GERSON, Director, Case Comprehensive Cancer Center, Professor of Hematological Oncology; Case Western Reserve University; Director, University Hospitals Seidman Cancer Center

LORI HOFFMAN HŌGG, Veterans Health Administration National Program Manager, Prevention Policy, National Center for Health Promotion and Disease Prevention; National Oncology Clinical Advisor, Office of Nursing Services, Department of Veterans Affairs

RUTH E. NEMIRE, President, ASK Educational Games, LLC

RANDALL A. OYER, Medical Director, Oncology, Ann B. Barshinger Cancer Institute, Penn Medicine Lancaster General Health

DAVID SIEGEL, LCDR, U.S. Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

2 As of February 2019, Dr. Abernethy’s affiliation is Principal Deputy Commissioner and Acting Chief Information Officer of Food and Drugs, Food and Drug Administration.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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VIRGINIA L. VALENTIN, Assistant Professor and Associate Director, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, University of Utah School of Medicine

ROBERT A. WINN, Associate Vice Chancellor, Community-Based Practice; Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of Illinois at Chicago; Director, University of Illinois Cancer Center

Project Staff

ERIN BALOGH, Senior Program Officer

RUTH COOPER, Senior Program Assistant

ANNALEE GONZALES, Administrative Assistant

EMILY ZEVON, Associate Program Officer

SHARYL J. NASS, Forum Director and Director, Board on Health Care Services

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
×

NATIONAL CANCER POLICY FORUM1

EDWARD J. BENZ, JR. (Chair), President and Chief Executive Officer Emeritus, Dana-Farber Cancer Institute; Richard and Susan Smith Distinguished Professor of Medicine, Genetics and Pediatrics, Harvard Medical School

GARNET L. ANDERSON, Senior Vice President and Director, Public Health Sciences Division, Fred Hutchinson Cancer Research Center; Affiliate Professor, Department of Biostatistics, University of Washington

KENNETH ANDERSON, Kraft Family Professor of Medicine, American Cancer Society Clinical Research Director, Jerome Lipper Multiple Myeloma Center, Harvard Medical School, Dana-Farber Cancer Institute

WILLIAM L. BAILEY, Vice President, Medical & Scientific Affairs Research & Development, Helsinn Therapeutics (U.S.), Inc.

KAREN BASEN-ENGQUIST, Annie Laurie Howard Research Distinguished Professor, Professor of Behavioral Science, and Director, Center for Energy Balance in Cancer Prevention and Survivorship, The University of Texas MD Anderson Cancer Center

CHRIS BOSHOFF, Chief Development Officer, Oncology, Global Product Development, Pfizer Inc.

CATHY J. BRADLEY, Associate Dean for Research, Colorado School of Public Health, Professor and Deputy Director, University of Colorado Cancer Center

OTIS W. BRAWLEY, Bloomberg Distinguished Professor, Department of Epidemiology, Bloomberg School of Public Health, Department of Oncology, School of Medicine, Johns Hopkins University

ROBERT W. CARLSON, Chief Executive Officer, National Comprehensive Cancer Network

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
×

NANCY E. DAVIDSON, President and Executive Director, Seattle Cancer Care Alliance; Senior Vice President, Director, and Full Member, Clinical Research Division, Fred Hutchinson Cancer Research Center; Head, Department of Medicine, Division of Medical Oncology, University of Washington

GEORGE D. DEMETRI, Professor of Medicine and Director, Ludwig Center, Harvard Medical School; Senior Vice President for Experimental Therapeutics, Dana-Farber Cancer Institute; Associate Director for Clinical Sciences, Dana-Farber/Harvard Cancer Center

JAMES H. DOROSHOW, Deputy Director for Clinical and Translational Research, National Cancer Institute

NICOLE F. DOWLING, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention

SCOT W. EBBINGHAUS, Vice President and Therapeutic Area Head, Oncology Clinical Research, Merck Research Laboratories

KOJO S. J. ELENITOBA-JOHNSON, Professor, Perelman School of Medicine; Director, Center for Personalized Diagnostics and Division of Precision and Computational Diagnostics, University of Pennsylvania

AWNY FARAJALLAH, Vice President, Head, US Medical Oncology, Bristol-Myers Squibb

STANTON L. GERSON, Director, Case Comprehensive Cancer Center; Professor of Hematological Oncology; Case Western Reserve University; Director, University Hospitals Seidman Cancer Center

LORI HOFFMAN HŌGG, Veterans Health Administration National Program Manager, Prevention Policy, National Center for Health Promotion and Disease Prevention; National Oncology Clinical Advisor, Office of Nursing Services, Department of Veterans Affairs

LINDA HOUSE, President, Cancer Support Community

HEDVIG HRICAK, Chair, Department of Radiology, Memorial Sloan Kettering Cancer Center

ROY A. JENSEN, President, Association of American Cancer Institutes; Director, The University of Kansas Cancer Center; William R. Jewell, M.D. Distinguished Masonic Professor, Kansas Masonic Cancer Research Institute

LISA KENNEDY SHELDON, Chief Clinical Officer, Oncology Nursing Society

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
×

SAMIR N. KHLEIF, Director, Jeannie and Tony Loop Immuno-Oncology Lab, Biomedical Scholar and Professor of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center

RONALD M. KLINE, Medical Officer, Patient Care Models Group, Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services

MICHELLE M. LE BEAU, Arthur and Marian Edelstein Professor of Medicine and Director, The University of Chicago Comprehensive Cancer Center

MIA LEVY, Director, Rush University Cancer Center; Associate Professor of Medicine, Division of Hematology and Oncology; System Vice President, Cancer Services, Rush System for Health

J. LEONARD LICHTENFELD, Interim Chief Medical Officer, American Cancer Society

NEAL J. MEROPOL, Vice President, Research Oncology, Flatiron Health

MARTIN J. MURPHY, Chief Executive Officer, CEO Roundtable on Cancer

RANDALL A. OYER, Medical Director, Oncology, Ann B. Barshinger Cancer Institute, Penn Medicine Lancaster General Health

RICHARD PAZDUR, Director, Oncology Center of Excellence; Acting Director, Office of Hematology and Oncology Products, Food and Drug Administration

RICHARD L. SCHILSKY, Senior Vice President and Chief Medical Officer, American Society of Clinical Oncology

DEBORAH SCHRAG, Chief, Division of Population Sciences, Professor of Medicine, Department of Medical Oncology, Harvard Medical School, Dana-Farber Cancer Institute

LAWRENCE N. SHULMAN, Professor of Medicine, Deputy Director for Clinical Services, and Director, Center for Global Cancer Medicine, Abramson Cancer Center, University of Pennsylvania

DAN THEODORESCU, Director, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center

VERENA VOELTER, Head, United States Oncology Clinical Development & Medical Affairs, Novartis Pharmaceuticals Corporation

GEORGE J. WEINER, C.E. Block Chair of Cancer Research, Professor of Internal Medicine, and Director, Holden Comprehensive Cancer Center, The University of Iowa

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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ROBERT A. WINN, Associate Vice Chancellor, Community-Based Practice; Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of Illinois at Chicago; Director, University of Illinois Cancer Center

National Cancer Policy Forum Staff

ERIN BALOGH, Senior Program Officer

RUTH COOPER, Senior Program Assistant

ANNALEE GONZALES, Administrative Assistant

NATALIE LUBIN, Research Assistant

MICAH WINOGRAD, Financial Officer

EMILY ZEVON, Associate Program Officer

SHARYL J. NASS, Forum Director and Director, Board on Health Care Services

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Reviewers

This Proceedings of a Workshop was read in draft form by Lauren Shern and Taryn Young within the National Academies of Sciences, Engineering, and Medicine to ensure the proceedings meets institutional standards for quality and objectivity while accurately reflecting the purpose and focus of the workshop.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Acknowledgments

Support from the many annual sponsors of the National Academies of Sciences, Engineering, and Medicine’s National Cancer Policy Forum is crucial to the work of the forum. Federal sponsors include the Centers for Disease Control and Prevention and the National Cancer Institute/National Institutes of Health. Non-federal sponsors include the American Association for Cancer Research, American Cancer Society, American College of Radiology, American Society of Clinical Oncology, Association of American Cancer Institutes, Association of Community Cancer Centers, Bristol-Myers Squibb, Cancer Support Community, CEO Roundtable on Cancer, Flatiron Health, Helsinn Therapeutics (U.S.), Inc., LIVESTRONG Foundation, Merck, National Comprehensive Cancer Network, Novartis Oncology, Oncology Nursing Society, and Pfizer Inc.

The forum wishes to express its gratitude to the expert speakers whose presentations helped further the dialogue and advance progress to better support the oncology careforce and improve the delivery of high-quality cancer care. The forum also wishes to thank the members of the planning committee for their work in developing an excellent workshop agenda.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Acronyms and Abbreviations

ACA Patient Protection and Affordable Care Act
ACCC Association of Community Cancer Centers
AMA American Medical Association
AMIA American Medical Informatics Association
APP advanced practice provider
ASCO American Society of Clinical Oncology
CEO chief executive officer
CMS Centers for Medicare & Medicaid Services
CSC Cancer Support Community
EHR electronic health record
FDA Food and Drug Administration
HPV human papillomavirus
IOM Institute of Medicine
NP nurse practitioner
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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OMH Oncology Medical Home
ONS Oncology Nursing Society
PA physician assistant
PCORI Patient-Centered Outcomes Research Institute
PTSD posttraumatic stress disorder
SCH Symptom Care at Home
VA Department of Veterans Affairs
VHA Veterans Health Administration
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Developing and Sustaining an Effective and Resilient Oncology Careforce: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25533.
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The oncology careforce faces challenges as population growth in the U.S. contributes to increases in the number of patients diagnosed with cancer. Significant advances in cancer research, screening and diagnostic practices, and treatment have led to the age-adjusted declining mortality rate from cancer. However, as the field continues to develop and advance, cancer care has become more complex than ever before. There is a growing concern regarding the U.S. health care system’s capacity to deliver high-quality cancer care to the increasing number of patients.

The National Academies convened a workshop on February 11-12, 2019 to explore trends in cancer care and identify opportunities for improvement in the rapidly developing oncology careforce. Discussions at the workshop primarily focused on trends in demographics, the careforce, and oncology practice, as well as implications for the future of cancer care and strategies to improve the organization and delivery of cancer care. Opportunities to change policy and leverage technologies in oncology were also identified. This publication summarizes the presentations and discussions from the workshop.

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