Preparing for an Epidemic: Cancer Care in an Aging Population

Abstract

The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer.KEY POINTSThe Institute of Medicine's Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population released a report September 2013 (“Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis”) with 10 recommendations to improve the quality of cancer care in.In consideration of the limited evidence on elderly patients with cancer and those with multiple chronic conditions, the committee called for research and funding for clinical studies that mirrors the age distribution and health-risk profile of patients with the disease.The committee also recommended that the research community expand the depth of the common set of data elements to include a more comprehensive geriatric assessment.Financial toxicity, defined as the undesirable financial consequences as a result of patients undergoing expensive treatment, is a growing concern in cancer care.Full disclosure of the costs and benefits of all available treatment options, especially for patients with advanced cancer, could improve the affordability and quality of cancer care.