Despite important gains in health insurance rates and cancer science, barriers to patient access to care remain a problem, according to the American Society of Clinical Oncology (ASCO) 2017 report on the state of cancer care. The report was published in the Journal of Oncology Practice.1

The report spotlighted examples of rapid change in clinical oncology, ranging from the “ongoing and bipartisan” Cancer Moonshot Initiative and expanded access to health insurance under the Affordable Care Act (the ACA, also known as “Obamacare”) to new physician reimbursement systems, electronic health records, and big data analytics.

In 2016, 1.7 million Americans were diagnosed with cancer and there were more than 15.5 million cancer survivors, the report stated.

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“Many individuals are caregivers and provide social support to patients with cancer, and the financial burden of cancer treatment can affect all aspects of family life, they wrote. “In addition, the general population is concerned about inherited and environmental cancer risks and detection, with many people participating in screening and prevention programs.”

By early last year, 20 million Americans had obtained health insurance under the ACA, the report authors noted. Yet 27 million Americans remain uninsured, and out-of-pocket expenses remain a significant affordability issue for patients and their families.

“A wide body of evidence ties insurance coverage to improved health outcomes, with several 2016 studies examining the relationship between insurance and receipt of cancer services or survival,” the authors noted. “But even for insured individuals, cancer care can be unaffordable. According to recent findings, approximately one third of working-age cancer survivors incurred debt as a result of their treatment.”

Medicare beneficiaries spent more than $8000, on average, in cancer-related out-of-pocket expenses — a quarter of their annual income, on average, according to the report.

“Independent of insurance status, wide disparities in cancer incidence and mortality exist among groups of Americans, especially with respect to race, ethnicity, and geography,” they noted.

ASCO urged continued federal funding for cancer research, including congressional support for the Moonshot Initiative “to ensure ongoing development and delivery of promising new treatments” to patients with cancer. Congress authorized funding for the initiative late last year as part of the 21st Century Cures Act to hasten innovation in cancer treatment research.

The report also emphasized the U.S. Food and Drug Administration (FDA)’s “key role” in moving new treatments into clinical practice.

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“Congress should ensure that the FDA has adequate resources and authority to review and approve therapies efficiently and quickly while also ensuring patient safety and the efficacy of the interventions,” the report stated.


  1. American Society of Clinical Oncology. The state of cancer care in America, 2017: a report by the American Society of Clinical Oncology. J Oncol Pract. 2017 Mar 22. doi: 10.1200/JOP.2016.020743 [Epub ahead of print]