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American Society of Clinical Oncology/National Comprehensive Cancer Network Quality Measures

Christopher E. Desch, Kristen K. McNiff, Eric C. Schneider, Deborah Schrag, Joan McClure, Eva Lepisto, Molla S. Donaldson, Katherine L. Kahn, Jane C. Weeks, Clifford Y. Ko, Andrew K. Stewart, Stephen B. Edge

From the National Comprehensive Cancer Network, Fort Washington, PA; American Society of Clinical Oncology, Alexandria, VA; Harvard School of Public Health, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; RAND, Santa Monica; David Geffen School of Medicine at UCLA, Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Commission on Cancer of the American College of Surgeons, Chicago, IL; Roswell Park Cancer Institute and the University at Buffalo, Buffalo, NY
Deceased. The authors wish to dedicate this work to Dr Desch, who died tragically during the manscript preparation

Corresponding author: Stephen B. Edge, MD, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, e-mail: stephen.edge{at}roswellpark.org

Purpose: The National Cancer Policy Board recommended the creation of quality measures and a national reporting system in 1999. Representatives from the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) collaborated to create metrics suitable for national performance measurement.

Methods: Content and methodology experts nominated by ASCO and NCCN met to select and refine metrics for breast, colon, and rectal cancer based on National Initiative for Cancer Care Quality and NCCN measures and NCCN and ASCO guidelines. Measures were selected based on their impact on disease free and overall survival, the degree to which opportunities for improvement exist, and the feasibility of data collection.

Results: Three breast cancer measures and four colorectal cancer measures were chosen. Measures for breast cancer included adjuvant hormone therapy for hormone receptor–positive tumors, chemotherapy for hormone receptor–negative cancer, and radiation after lumpectomy. Colorectal measures included adjuvant radiation and chemotherapy for rectal cancer, and adjuvant chemotherapy for colon cancer. All but one were recommended as accountability measures and one for quality improvement (removal and examination of 12 or more lymph nodes in colon cancer). Specifications were developed for each measure using tumor registries as the data source.

Conclusion: ASCO/NCCN measures can be implemented by health systems, provider groups or payors for improvement or accountability using local tumor registries to furnish data on staging and treatment.

Supported by the American Society of Clinical Oncology and the National Comprehensive Cancer Network.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.