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Cancer Care Scores Higher Marks

As Americans fret about the quality of their health care, it appears cancer patients are experiencing improvements in treatment. A major study conducted by the Rand Group found that all Americans—whether wealthy or poor, black or white—are likely to receive better care for cancer than anything else.

Findings published in the New England Journal of Medicine show that patients receive proper medical attention for heart disease and other conditions only about 55 percent of the time. But a separate study by the same group suggests that the quality of cancer care is getting substantially better.

Looking at patients who suffered from either colon or breast cancer, at least three fourths received the recommended care, according to findings published in the Journal of Clinical Oncology. The researchers looked at several broad areas, including detection, surgery, drug therapy and follow-up care. For colon cancer, 78 percent of patients were treated according to agreed-upon guidelines, while for breast cancer, 84 percent of patients received quality care.

"[Care for] cancer is a bit better than other conditions," says Dr. Eric Schneider, a health policy expert at Harvard who helped conduct the Rand group's cancer study. The recent treatment advances have been a driving force.

"There is much higher quality now than just five years ago," he says.

Another potential factor, he adds, is that the disease is seen as a major battle. Since the war on cancer was declared in the 1970s, there has been a major investment in research, with both patients and physicians seemingly more engaged in fighting the disease.

"A large number of cancer specialists are looking over each others' shoulders," he says.

Indeed, Schneider points to the level of attention devoted to cancer as a way of improving the current health care mess. The Rand team blames a "fragmented and chaotic" system that makes it hard to deliver quality service for many chronic conditions. Specialized cancer centers, which bring together different doctors and nurses to treat patients, are growing more commonplace and may offer a model for other diseases.

"It's a team effort," Schneider explains, adding that such coordination can lead to better quality care for the patient.

Still, the one dark cloud on the horizon is the increasing expense of cancer treatments. In a recent speech to business leaders, Dr. Scott Gottleib of the Food and Drug Administration said that cancer costs might be brought under control if new therapies are developed more quickly and at a lower price.

"But right now, the opposite is happening," he said at the Annual Cancer Progress Conference, held in New York. The number of new drugs has reached a twenty-year low, while the overall costs of treating cancer have skyrocketed to more the $156 billion a year. "That's an astonishing figure," said Gottleib, pointing out that the expense is larger than the "gross domestic product of all but a few nations."

"It's hard to predict what will happen with financing cancer care," says Schneider. "Everyone is struggling with higher medical costs."