Panel Focuses on Guidelines’ Role in Quality Cancer Care

BUFFALO, NY—The third and final meeting of the President’s Cancer Panel this year focused on defining the role of practice guidelines in the quest for quality cancer care.

“The use of guidelines is not new; they are an accepted resource today with the rapid changes in health care, particularly with the emergence of for-profit managed care,” Harold P. Freeman, MD, chair of the panel, said at the meeting hosted by the Roswell Park Cancer Institute.

Dr. Freeman is director of Surgery, Harlem Hospital Center. The other members of the panel are Frances M. Visco, JD, president, National Breast Cancer Coalition, and Paul M. Calabresi, MD, director, Brown-Tufts Cancer Center.

One area of particular concern, Dr. Freeman said, is to design guidelines for current practice without limiting future therapies. Guidelines are necessary to assure that appropriate care is given under appropriate circumstances, most often using the “gold standard” treatment for a particular type of cancer, he said.

“However, any discussion of cancer treatment must also include investigational clinical research trials, since access to clinical trials is often associated with state-of-the-art cancer care,” Dr. Freeman added.

During the meeting, the Panel heard from Roswell Park physicians, who described how claims data from a local HMO are being used to examine patterns of breast cancer care in the area and compare these practices with those recommended in the National Comprehensive Cancer Network (NCCN) guidelines .

Representatives from the NCCN, the American Society of Clinical Oncology (ASCO), the American Association of Cancer Institutes (AACI), and other organizations reviewed the use of guidelines from the viewpoint of the professional societies .

In addition, physicians from health care organizations, including the American Association of Health Plans and the National Committee for Quality Assurance, discussed the importance of practice guidelines in the managed care industry .