The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop in March 2021 to examine the existing evidence base on how the Patient Protection and Affordable Care Act (ACA) has altered the landscape of cancer prevention and care delivery in the United States. The workshop featured presentations and discussions reviewing the effects of the ACA on people at risk for or living with cancer and providing insight into remaining policy challenges that could inform future efforts to improve and support the delivery of high-quality cancer care across the care continuum. This publication provides a high-level summary of the discussions presented during the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10?11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Despite advances in the delivery of high-quality cancer care and improvements in patient outcomes in recent years, disparities in cancer incidence, care, and patient outcomes persist. To examine opportunities to improve health equity across the cancer care continuum, the National Cancer Policy Forum and the Roundtable on the Promotion of Health Equity hosted a public workshop, Promoting Health Equity in Cancer Care, on October 25 and October 26, 2021. This virtual workshop featured presentations and panel discussions on topics that included: opportunities to improve equitable access to affordable, high-quality cancer care; strategies to identify and address the intersectionality of structural racism and implicit bias in cancer care delivery; the potential for quality measurement and payment mechanisms to incentivize health equity in cancer care delivery; and clinical practice data collection efforts to better assess and care for people living with and beyond cancer. This publication summarizes the presentation and discussion of the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

To examine the potential role of companion animals as sentinels of relevant, shared environmental exposures that may affect human aging and cancer, the National Cancer Policy Forum held a workshop in collaboration with the Forum on Aging, Disability, and Independence and the Standing Committee on the Use of Emerging Science for Environmental Health Decisions to explore this promising and underutilized pathway for research. Presentations and panel discussions covered the current state of the science and pathways for accelerating research, along with opportunities and challenges for using this novel translational approach to exposure science to advance human health. This Proceedings of a Workshop outlines the presentations and discussions that occurred during the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Biographical Sketches of Planning Committee Members and Workshop Speakers

The COVID-19 pandemic has led to dramatic adjustments in cancer care delivery and cancer research. To examine these changes, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop, Innovation in Cancer Care and Cancer Research in the Context of the COVID-19 Pandemic, in July 2021. Workshop speakers considered the lessons learned from these adaptations in order to improve the delivery of high-quality cancer care and the conduct of cancer clinical trials in the post-pandemic era. This Proceedings of a Workshop highlights presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Cancer treatment can lead to an array of significant short- and long-term physical, psychosocial, and socioeconomic consequences for patients and their families. To examine the opportunities to prevent and mitigate the adverse effects of cancer treatment, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop, Addressing the Adverse Consequences of Cancer Treatment, in November 2020. This workshop was convened by the Academies' National Cancer Policy Forum in collaboration with the Forum on Aging, Disability, and Independence. Workshop presentations and discussions described the range of adverse effects that patients with cancer may experience across the life course, and highlighted potential strategies to improve quality of life for cancer survivors and their families. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Digital health encompasses a broad array of tools and strategies with the goals of advancing research, increasing health care access and quality, and making care more personalized. It encompasses health content, digital health interventions, and digital applications, such as communication tools connecting patients and clinicians (e.g., secure email in the patient portal, text, chat, video visit), remote monitoring tools, clinical decision support tools, and systems for exchanging health information. Patient-facing tools, tools for clinicians, and systems to facilitate research and care improvement are all part of this diverse landscape, and each raises unique opportunities and potential challenges. To examine key policy issues for the effective and safe development, implementation, and use of digital health technologies in oncology research and care, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a virtual workshop in collaboration with the Forum on Cyber Resilience. The workshop, Opportunities and Challenges for Using Digital Health Applications in Oncology, held on July 13-14, 2020, convened a broad group of experts, including clinicians and researchers; patient advocates; and representatives of federal agencies, health professional societies, health care organizations, insurers, and the pharmaceutical and health technology industries. Many workshop speakers found the opportunities presented by digital health tools to be particularly compelling for oncology; however, capitalizing on these opportunities necessitates careful attention to the design, implementation, and use of digital health technologies. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Health literacy is a critical skill for engaging in healthy behaviors to reduce disease risk and improve health outcomes across the continuum of cancer care. However, estimates suggest that more than one-third of the U.S. adult population has low health literacy, and nearly half of all patients with cancer have difficulty understanding information about their disease or treatment. Low health literacy among patients with cancer is associated with poor health and treatment outcomes, including lower adherence to treatment, higher rates of missed appointments, and an increased risk of hospitalization. Low health literacy can also impede informed decision making, especially as cancer care becomes increasingly complex and as patients and their families take more active roles in treatment decisions. To examine opportunities to improve communication across the cancer care continuum, the National Cancer Policy Forum collaborated with the Roundtable on Health Literacy to host a workshop, Health Literacy and Communication Strategies in Oncology, July 15-16, 2019, in Washington, DC. Patients, patient advocates, clinicians, and researchers, representatives of health care organizations, academic medical centers, insurers, and federal agencies explored the challenges of achieving effective communication in cancer care. This publication summarizes the presentations and discussions of the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Scientists and clinicians seek a new paradigm that could improve the efficiency, cost-effectiveness, and overall success rate of cancer clinical trials, while maintaining the highest standards of quality. To explore innovative paradigms for cancer clinical trials and other ways to improve their quality, the National Cancer Policy Forum held a workshop, Improving the Quality of Cancer Clinical Trials, in Washington, DC. The main goals of the workshop were to examine new approaches to clinical trial design and execution that would: (1) better inform decisions and plans of those responsible for developing new cancer therapies (2) more rapidly move new diagnostic tests and treatments toward regulatory approval and use in the clinic (3) be less costly than current trials The resulting workshop summary will serve as input to the deliberations of an Institute of Medicine committee that will develop consensus-based recommendations for moving the field of cancer clinical trials forward. Table of Contents Front Matter Introduction New Clinical Trial Designs Molecular Imaging Screening for Predictive Markers Costs of Clinical Trials Regulatory Issues Reports from the Case Study Discussion Groups Concluding Remarks References Acronyms Glossary Appendix A: Workshop Agenda Appendix B: Workshop Speakers, Moderators, and Invited Discussants

The NCI-sponsored cooperative groups have made important contributions to improving treatment for many types of cancer, including breast, ovarian, colorectal, and childhood cancers. Cooperative group research has been instrumental in establishing innovative treatments that improve outcomes and quality of life. Despite these successes, the Cooperative Group Program has faced a number of challenges that threaten its effectiveness. To address this problem, the National Cancer Policy Forum (NCPF) convened a workshop titled "Multi-Center Phase III Clinical Trials and NCI Cooperative Groups" in Washington, DC, on July 1-2, 2008. The purpose of the workshop was to outline the challenges that the public clinical cancer research enterprise faces, and to identify possible solutions to these challenges. Table of Contents Front Matter Introduction Session 1A: Organization of the NCI Clinical Trials System Session 1B: Lessons from Non-Cooperative Group Multi-Center Clinical Trials Session 2: Barriers to Patient Recruitment and Physician Participation Session 3: Data Collection Standards and Monitoring Session 4: Costs of Cooperative Group Clinical Trials Summary and Wrap-Up References Abbreviations and Acronyms Glossary Appendix A: Workshop Agenda Appendix B: Workshop Speakers Appendix C: Letter from John Niederhuber, Director of the National Cancer Institute, to Members of the National Cancer Policy Forum