Guiding Cancer Control A Path to Transformation (2019) / Chapter Skim
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Pages 1-10
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From page 1... ...
Now, it is well known that cancer is a vast and evolving multitude of individual diseases with different biological mechanisms and different responses to treatments, but with a single overarching characteristic in common -- the unchecked proliferation of the body's own cells. Cancers can occur in many human tissues and organs, and there may be many different subtypes that can be identified based on molecular abnormalities, yielding potentially hundreds of different types of cancers.
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From page 2... ...
In the United States, however, cancer control efforts have evolved over time without a unifying national plan or centralized guidance. Numerous federal agencies have diverse roles in cancer control, but there is little cross-agency coordination, and each state and territory develops its own cancer control plan, with no overarching strategy or guiding vision of how an ideal cancer control system should operate or perform.
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From page 3... ...
Based on that review, the committee will consider potential actions to • Establish comprehensive national goals for cancer control; • Identify potential mechanisms to evaluate and advance progress toward these goals; • Identify challenges to achieving these goals and highlight knowledge gaps that impede progress in cancer control; • Foster collaboration and coordination among key stakeholders, clarifying roles in cancer control efforts, and to build on existing efforts and to develop and implement plans of action to overcome challenges; and • Prioritize cancer control interventions that have the potential to achieve significant progress in improving population health and reducing health disparities. The committee will issue a report with findings and recommendations to achieve progress in developing and implementing a national cancer control strategy.
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From page 4... ...
For example, the learning health care system model strives to enable evidence-informed transformations by continually collecting and using data to systematically integrate new knowledge into care delivery processes and to improve outcomes and motivate greater collaboration among all participants. Other systems frameworks have also been used to assess and improve certain aspects of cancer control efforts across the continuum.
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From page 5... ...
Although a search of the literature has uncovered no suggestions for using systems engineering approaches to understand the total system of cancer control, as this report is proposing, there have been a number of ideas and initial efforts related to the use of systems engineering concepts to understand individual components of cancer control. Published papers have discussed applying systems engineering techniques to cancer drug delivery, cancer survivorship, clinical care and patient safety, and efforts to reduce disparities in cancer outcomes.
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From page 6... ...
Indeed, this report has a different vision and ambition; it provides a higher level view on the progress made and yet to be made in cancer control and on what is still unclear about the various cancer control interventions and policy strategies. This report does not supply a construction blueprint that may be relevant only to one particular time, entity, or context because another conclusion of this report is: "The design of a single top-down, static blueprint for cancer control programs and operations in the United States is currently neither realistic nor productive. Instead, greater effectiveness in cancer control requires centrally available customizable planning tools that are useful across contexts and that can actively support performance monitoring and accountability reviews.
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From page 7... ...
Improve, where feasible, effective, and affordable, the avail ability of preventive, screening, diagnostic, and therapeutic interventions. Encourage timely palliative care, hospice care, survivorship services, and related social services according to the preferences and values of patients and their families.
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From page 8... ...
The Government Accountability Office should periodically review and report to the relevant congressional committees about the achieve ment of goals specified in the plan. A national cancer control plan will need to include all these federal participants, as well as ongoing participation from state and local governments and key participants in the for-profit and nonprofit sectors to undertake a comprehensive review of diverse and shifting needs and an integration of available resources and capabilities.
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From page 9... ...
For example, the U.S. Global Change Research Program, the NextGen air control system, biodefense initiatives, and intelligence community operations all require resource integration, joint monitoring, and diligent performance review across many different agencies, particularly involving industrial partnership.
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From page 10... ...
Thus, everyone has a stake in decisions about cancer control, which makes it crucial that the process of making those decisions be open and accountable. Successful national cancer control efforts will require a significant integration of resources and a major collaborative initiative among multiple participants to develop a joint ability with joint accounting and accountability.
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