The ACS supports the wise use of medicine. We advocate for the rational use of medical care in order to reduce the rationing of medical care. Society needs to appreciate the body of scientific and medical literature showing what prevention and treatment interventions are proven effective and how often those effective measures are not practiced. Thousands of American lives are lost daily because these Americans are unable to benefit from current medical knowledge.
The ACS is an advocate for science. We support the development and use of evidence-based medicine. Today, much of the practice of medicine is opinion of the individual physician. Comparative effectiveness research (CER) has the potential of finding more effective treatments at a lower cost. Some CER has already been done in oncology under a different name, the large phase III randomized trial. The guidelines of the National Comprehensive Cancer Network are often based on assessment of these trials. These guidelines are highly regarded but often not used.
The ACS convenes groups of unbiased experts to review the scientific literature and produce cancer prevention and screening guidelines and recommendations based on what is shown to save lives using accepted scientific principles . These guidelines are highly respected, but often not practiced. Nearly half of all adults aged >50 years have never been screened for colon cancer, yet stool blood testing at a cost of $10 a year has been shown to reduce the risk for colon cancer death by ≥35%.
Numerous studies, some supported or conducted by the ACS, show that the medically underserved have greater difficulty accessing cancer screening and prevention . If symptomatic, they have greater difficulty getting evaluated and diagnosed. They usually have disease detected at a later stage. If diagnosed, they have greater difficulty getting adequate treatment. Some of the difficulty is simply affording care, but there are other reasons for poor outcomes such as lack of transportation to health care facilities, poor health literacy leading to noncompliance, and fear of the medical system .
Some reasons for the higher costs of U.S. health care include the large number of patients presenting with serious diseases late and the overuse of emergency rooms by patients who do not have a relationship with a physician. The “medical home” concept, if fully implemented, has the potential to decrease the misuse of emergency departments. Every person, even the healthy, is assigned a physician. The medical home concept increases emphasis on prevention of disease.
The ACS has instituted programs to assist cancer patients. The HIAS works to help patients find needed funding. There are transportation and navigation programs to improve adherence to treatment. The NCIC is available by internet or 800 number 24 hours a day, 7 days a week. It has publications and programs to increase health literacy