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July 2012, Volume 39, Number 4


Oncology Nursing Society Position

Access to Quality Cancer Care


Cancer is the second leading cause of death in the United States, with the majority of new cancer diagnoses occurring among those aged 65 and older (Siegel, Naishadham, & Jemal, 2012). Access to quality cancer care is the right of all people. Quality care demands safety; efficacy; timeliness; a patient-centered approach, coordinated by a multidisciplinary team; and the integration of evidence-based practice to continuously improve care (Institute of Medicine, 2011). Without essential services targeted at reducing cancer risk, morbidity, and mortality, patients with cancer may suffer from decreased quality of life or less-than-optimal outcomes. Those services are prevention, early detection, risk reduction, clinical trials, treatment, psychosocial care, and survivorship.


Healthcare coverage, including Medicare and the 2010 Affordable Care Act, is essential in providing access to services that ensure quality cancer care. Lack of insurance or inadequate healthcare coverage adversely impacts health on multiple levels. The uninsured are less likely to receive preventive care and more likely to receive inadequate or delayed treatment and die prematurely than people with health insurance coverage.


To ensure quality cancer care, the Oncology Nursing Society (ONS) affirms the substantive role of oncology nursing in decision making and the integration of oncology nursing as an equal administrative and practice partner in the planning and implementation of cancer care services.


It Is the Position of ONS That


         Comprehensive healthcare coverage with respect to cancer prevention, early detection, cancer risk assessment, risk reduction services, genetic counseling, and genetic predisposition testing is available to everyone through continuous health insurance coverage, irrespective of personal or family health history or preexisting conditions.


         Healthcare coverage is accessible and affordable and includes consumer choice and control.


         Evidence-based conventional and integrative therapies, including regimens incorporating off-label therapies approved by the U.S. Food and Drug Administration, comprehensive symptom management, psychosocial care, long-term survivorship, and rehabilitation services, are options for every patient with cancer.

         All individuals have affordable access to the full range of proven-effective tobacco cessation strategies and therapies. Services provided by professional oncology nurses, including advanced practice nurses who are competent in the essentials of oncology nursing and the administration of oncologic therapies, are accessible and eligible for reimbursement.


         The full range of services provided by advanced practice nurses is accessible and eligible for reimbursement.


         Health disparities and access to care and treatment challenges are addressed for at-risk and underserved populations.


         Everyone, regardless of age, gender, race, or ethnicity, has the opportunity to participate in clinical trials for cancer prevention and comprehensive cancer care, including those coordinated by nurses educated and certified in oncology nursing, allowing for continuing informed consent.


Approved by the ONS Board of Directors, 3/2012.




Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. Retrieved from http://www.nap.edu/catalog/12956.html


Siegel, R., Naishadham, D., & Jemal, A. (2012). Cancer statistics, 2012. CA: A Cancer Journal for Clinicians, 62, 1029. http://dx.doi.org/10.3322/caac.20138