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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Examining Access to Nutrition Care
in Outpatient Cancer Centers

Proceedings of a Workshop

Leslie Pray and Ann L. Yaktine, Rapporteurs

Food and Nutrition Board

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. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by the Academy of Nutrition and Dietetics (AND), Alcresta, Inc., the American Cancer Society, the American Institute for Cancer Research, the AND Foundation, The Annie Appleseed Project, the Clinical Nutrition Management Dietetics Practice Group of the AND, Medtrition, the National Cancer Institute, the National Institutes for Health (NIH), the NIH Office of Dietary Supplements, the Oncology Nutrition Dietetic Practice Group of the AND, OptionCare, and Savor Health. 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: 978-0-309-44585-6
International Standard Book Number-10: 0-309-44585-X
Digital Object Identifier: 10.17226/23579

Additional copies of this publication are available for sale 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 2016 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. 2016. Examining access to nutrition care in outpatient cancer centers: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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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.

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

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Reports document the evidence-based consensus of an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and committee deliberations. Reports are peer reviewed and are approved by the National Academies of Sciences, Engineering, and Medicine.

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

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

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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PLANNING COMMITTEE ON ASSESSING RELATIONSHIPS BETWEEN ACCESS TO STANDARDIZED CARE AND HEALTH OUTCOMES AND COST-EFFECTIVENESS OF CARE IN OUTPATIENT CANCER CENTERS1

CHERYL ROCK (Chair), Professor, Department of Family Medicine and Public Health, Cancer Prevention and Control Program, University of California, San Diego

KIM ROBIEN (Vice-Chair), Associate Professor, Exercise and Nutritional Science, Epidemiology and Biostatistics, The George Washington University

STEVEN K. CLINTON, Professor of Internal Medicine, Division on Hematology and Oncology, The Ohio State University

WENDY JOHNSON-ASKEW, Director of Public Policy, Nestlé Nutrition, North America

MARIAN NEUHOUSER, Member, Cancer Prevention Program, Public Health Services Division, Fred Hutchinson Cancer Research Center

NICO PRONK, Vice President for Health Management/Health Chief Officer, HealthPartners Institute

Health and Medicine Division Staff

ANN L. YAKTINE, Project Director and Director, Food and Nutrition Board

NOA NIR, Senior Program Assistant

Consultant

MEI CHUNG, Tufts University

___________________

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.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Reviewers

This Proceedings of a Workshop has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published Proceedings of a Workshop as sound as possible and to ensure that the Proceedings of a Workshop meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this Proceedings of a Workshop:

Nancy J. Emenaker, National Cancer Institute

Kelly Kelleher, Nationwide Children’s Hospital

Colleen Spees, The Ohio State University College of Medicine

Cynthia Thomson, University of Arizona Cancer Center and Mel & Enid Zuckerman College of Public Health

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the Proceedings of a Workshop before its release. The review of this Proceedings of a Workshop was overseen by Nancy E. Adler, University of California, San Francisco. She was responsible for making certain that an independent examination of this Proceedings of a Workshop was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this Proceedings of a Workshop rests entirely with the rapporteurs and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Acronyms and Abbreviations

ACCC

Association of Community Cancer Centers

ACO

accountable care organization

ACS

American Cancer Society

AICR

American Institute for Cancer Research

AND

Academy of Nutrition and Dietetics

ANDHII

Academy of Nutrition and Dietetics Health Informatics Infrastructure

ASCO

American Society for Clinical Oncology

ASTRO

American Society for Radiation Oncology

BMI

body mass index

CDHP

consumer-driven health plan

CDR

Commission on Dietetic Registration

CMMI

Center for Medicare & Medicaid Innovation

CMS

Centers for Medicare & Medicaid Services

CoC

American College of Surgeon’s Commission on Cancer

COE

center of excellence

COPD

chronic obstructive pulmonary disease

COSA

Clinical Oncology Society of Australia

CPT

Current Procedural Terminology

CSO

Board Certified Specialist in Oncology Nutrition

DIANA-5

Diet and Androgens-5 study

DSHEA

Dietary Supplement Health and Education Act of 1994

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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EAL

Evidence Analysis Library

ENERGY

Exercise and Nutrition to Enhance Recovery and Good Health for You Trial

FDA

U.S. Food and Drug Administration

FNCE

Food and Nutrition Conference Expo

FTE

full-time equivalent

GI

gastrointestinal

GP

General Practitioner

ICD

International Classification of Diseases

IEN

immune-enhancing nutrition

IOM

Institute of Medicine

NBGH

National Business Group on Health

NCCCP

National Comprehensive Cancer Control Program

NCCN

National Cooperative Cancer Network

NCI

National Cancer Institute

NEL

U.S. Department of Agriculture’s Nutrition Evidence Library

NIH

National Institutes of Health

NIS

nutrition impact symptom

ONDPG

Oncology Nutrition Dietetic Practice Group

PEG

percutaneous endoscopic gastrostomy

PG-SGA

Patient Generated Subjective Global Assessment

PIVOT

Prostate Cancer Intervention Versus Observation Trial

RCT

randomized controlled trial

RD

registered dietitian

RDN

registered dietitian nutritionist

RENEW

Reach Out to ENhancE Wellness in Older Survivors

SNAQ

Short Nutritional Assessment Questionnaire

WCRF

World Cancer Research Fund International

WHEL

Women’s Healthy Eating and Living Study

YMCA

Young Men’s Christian Association

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
×
Page R8
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Page R9
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Page R10
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Page R11
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Examining Access to Nutrition Care in Outpatient Cancer Centers: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23579.
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Page R12
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An estimated 90 percent of oncology patients in the United States receive treatment in outpatient cancer centers and clinics. This change from the older model of inpatient care has important implications for overall quality of care for oncology patients and nutritional care in particular. Amidst growing concern about access to oncology nutrition services, combined with growing recognition of the importance of providing nutritional care to optimize oncology treatment outcomes and maximize quality of life among both patients and survivors of cancer, the National Academies of Sciences, Engineering, and Medicine convened a public workshop in March 2016 to explore evolving interactions between nutritional care, cancer, and health outcomes.

Participants explored how health outcomes and survival of cancer patients in outpatient cancer centers are affected by current standards for nutritional services, nutritional interventions, and benefits associated with oncology patient access to medical nutrition therapy. They also studied the cost of outpatient nutritional care and assessed cost–benefit relationships between oncology nutrition services and health outcomes and survival. This publication summarizes the presentations and discussions from the workshop.

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