JCO Early Release, published online ahead of print Dec 15 2008
Journal of Clinical Oncology, 10.1200/JCO.2008.16.3691
Received February 20, 2008
Accepted August 6, 2008
American Society of Clinical Oncology Policy Statement: The Role of the Oncologist in Cancer Prevention and Risk Assessment
Robin T. Zon, Elizabeth Goss, Victor G. Vogel, Rowan T. Chlebowski, Ismail Jatoi, Mark E. Robson, Dana S. Wollins,* Judy E. Garber, Powel Brown, and Barnett S. Kramer
From the Michiana Hematology-Oncology, South Bend, IN; Turner & Goss LLP, Washington, DC; Magee/UPCI Breast Cancer Prevention Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA; Division of Medical Oncology and Hematology, Harbor UCLA Medical Center, Torrance, CA; Breast Care Center, National Naval Medical Center; National Institutes of Health, Bethesda, MD; Clinical Genetics Services, Memorial Sloan-Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; Dana-Farber Cancer Institute, Boston, MA; and Baylor College of Medicine, Houston, TX.
* To whom correspondence should be addressed. E-mail: dana.wollins{at}asco.org
Oncologists have a critical opportunity to utilize risk assessment and cancer prevention strategies to interrupt the initiation or progression of cancer in cancer survivors and individuals at high risk of developing cancer. Expanding knowledge about the natural history and prognosis of cancers positions oncologists to advise patients regarding the risk of second malignancies and treatment-related cancers. In addition, as recognized experts in the full spectrum of cancer care, oncologists are afforded opportunities for involvement in community-based cancer prevention activities.
Although oncologists are currently providing many cancer prevention and risk assessment services to their patients, economic barriers exist, including inadequate or lack of insurance, that may compromise uniform patient access to these services. Additionally, insufficient reimbursement for existing and developing interventions may discourage patient access to these services.
The American Society of Clinical Oncology (ASCO), the medical society representing cancer specialists involved in patient care and clinical research, is committed to supporting oncologists in their wide-ranging involvement in cancer prevention. This statement on risk assessment and prevention counseling, although not intended to be a comprehensive overview of cancer prevention describes the current role of oncologists in risk assessment and prevention; provides examples of risk assessment and prevention activities that should be offered by oncologists; identifies potential opportunities for coordination between oncologists and primary care physicians in prevention education and coordination of care for cancer survivors; describes ASCO's involvement in education and training of oncologists regarding prevention; and proposes improvement in the payment environment to encourage patient access to these services.
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