Commission on Cancer

View all recommendations from this society

Released September 4, 2013

Don’t initiate surveillance testing after cancer treatment without providing the patient a survivorship care plan.

  • Inappropriate or overused testing after cancer treatment is common, but provides no value in surveillance for recurrence and often leads to other unnecessary tests, potential morbidity, anxiety, uncertainty and higher cost.
  • A survivorship care plan provides the patient and their primary providers an evidence-based road map for surveillance testing and supportive care.
  • The Institute of Medicine identified the need for a survivorship care plan as a key factor to help cancer patients transition to long term surveillance care, avoid unnecessary services, and seek appropriate rehabilitative care and emotional support.
  • A survivorship care plan includes a summary of the type and stage of the cancer, treatment received, the plan for type and frequency of surveillance testing, and information on resources for rehabilitative and supportive care.
  • Templates for survivorship care plans are available from organizations including the Livestrong Foundation, the National Coalition for Cancer Survivorship, and the American Society of Clinical Oncology.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American College of Surgeons concluded in its review of this opportunity that it was optimal to submit a separate list of interventions related to cancer from the American College of Surgeons Commission on Cancer. The Commission on Cancer appointed a multidisciplinary task force that met in person in September, 2012 and subsequently by conference call and electronic communications.

Recommendations for candidate interventions were solicited from panel members and other leaders from the Commission on Cancer. These panel members were provided a written charge to identify measures that would support the Commission’s standards for accreditation in use in more than 1,500 cancer programs across the U.S. In addition, panel members were provided with a full description of the Choosing Wisely®campaign and the interventions previously recommended by other organizations both for cancer and all other disorders.

Following initial submission of the candidate interventions, the panel discussed each intervention specifically evaluating the significance of the intervention, the potential scope of variation in care affected by the intervention, and the potential numbers of persons affected by this. The group also discussed the impact on short-term and long-term cost to be gained by implementation of each intervention. The panel voted on each intervention to select the final list of recommended interventions. The panel members then reviewed and refined the wording of each intervention and completed the bulleted supporting documentation and literature citations. The final list of interventions was then approved by the panel and submitted to the leadership of the American College of Surgeons for final approval. The Commission on Cancer’s disclosure and conflict of interest policy can be found at www.facs.org.

Commission on Cancer Panel Members

  • Stephen Edge, MD, FACS, Chair, Roswell Park Cancer Institute, Buffalo, NY
  • David Bentrem, MD, FACS, Northwestern Memorial Hospital, Chicago, IL
  • Daniel Kollmorgen, MD, FACS, University of Iowa, Des Moines, IA
  • Daniel McKellar, MD, FACS, Wayne Healthcare, Greenville, OH
  • Christopher Pezzi, MD, FACS, Abington Memorial Hospital, Abington, PA
  • Lee Wilke, MD, FACS, University of Wisconsin Health System, Madison, WI
  • David Winchester, MD, FACS, Medical Director, Cancer Programs, American College of Surgeons

Sources

Hewitt M, Greenfield S. Stovall E . From cancer patient to cancer survivor: lost in transition. Washington: National Academies Press; 2005, 506 p.

Hahn EE, Ganz PA. Survivorship programs and care plans in practice: variations on a theme. J Oncol Practice. 2011;7(2):70-5.

Ligibel JA, Denlinger CS. New NCCN guidelines for survivorship care. J Natl Compr Canc Netw. 2013;11(5 Suppl):640-4.

Cowens-Alvarado R, Sharpe K, Pratt-Champman M, Willis A, Gansler T, Ganz PA, Edge SB, McCabe MS, Stein K. Advancing survivorship care through the National Cancer Survivorship Resources Center: Developing American Cancer Society guidelines for primary care providers. CA Cancer J Clin. 2013;63(3):147-150.

Khatcheressian JL, Hurley P, Bantug E, Esserman LJ, Grunfeld E, Halberg F, Hantel A, Henry NL, Muss HB, Smith TJ, Vogel VG, Wolff AC, Somerfield MR, Davidson NE; American Society of Clinical Oncology. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2013 Mar 1;31(7):961-5.

Desch CE, Benson AB, Somerfield MR. Colorectal cancer surveillance: 2005 updated of an American Society of Clinical Oncology practice guideline. J Clin Oncol. 2005;33:8512-19.