Need for standardization of cancer practice via nationally accepted treatment guidelines.

The critical need for a reduction in health-care costs has revolutionized the management of a significant segment of the American health-care system. The competition, at least on the basis of cost, will continue to restrict access to care and may reduce quality. For patients with diseases such as specific cancers that have been demonstrated by reproducible methods in comparative trials to be potentially curable or strikingly ameliorated, assurance of treatment by these methods must be guaranteed. Achievement of a national consensus on cancer treatment guidelines for potentially curable cancers is needed as the benchmark of quality health-care plans for patients and payors alike. Documenting adherence to such guidelines and finding mechanisms for improving treatments for future patients remain unresolved challenges of the managed-care era.