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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the National Cancer Policy Board, which is responsible for the report, were chosen for their special competences and with regard for appropriate balance.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

This study was supported through funding provided by the National Cancer Institute (Contract No. NO2-CO-71024); the Centers for Disease Control and Prevention; the American Cancer Society; Amgen, Inc.; Abbott Laboratories; and Hoechst Marion Roussel, Inc. The views presented in this report are those of the National Cancer Policy Board and are not necessarily those of the funding organizations.

The full text of this report is available on line at

For more information about the Institute of Medicine and the National Cancer Policy Board, visit

Library of Congress Cataloging-in-Publication Data

Ensuring quality cancer care / Maria Hewitt and Joseph V. Simone, editors ; National Cancer Policy Board, Institute of Medicine and Commission on Life Sciences, National Research Council.

p. cm.

Includes bibliographical references and index.

ISBN 0-309-06480-5 (pbk.)

1. Cancer—Treatment—United States. 2. Cancer—Treatment—Quality control. 3. Cancer—Patients—Care—United States. I. Hewitt, Maria Elizabeth. II. Simone, Joseph V. III. National Cancer Policy Board (U.S.)

RA645.C3 E57 1999




Cover: Constellation Cancer, the Crab. “Cancer” comes from the Latin word meaning “crab, malignant tumor.”

Copyright 1999 by the National Academy of Sciences. All rights reserved.

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