Abcarian Lecture will highlight future cancer framework


Heidi Nelson, MD, FACS
Heidi Nelson, MD, FACS

The American College of Surgeons (ACS) is jump-starting celebrations for the 100th anniversary of the Commission on Cancer (CoC) with a look at the CoC’s enduring vision for cancer care. Today’s goal of improving outcomes for patients with cancer is virtually unchanged from the CoC’s initial framework.

“This is a unique moment in time to look back and forward at the same time at the factors that have driven improvements in cancer care for the past 100 years,” said Heidi Nelson, MD, FACS, Medical Director, ACS Cancer Programs. “There are some important and fascinating lessons learned from the ways the framers set up a commission in 1922 that will help us remain relevant and successful for the next 100 years.”

Dr. Nelson will deliver the 2021 Herand Abcarian Lecture, 100 Years of Quality: Lessons for the Next 100 Years, at 9:00 am Central Time on Tuesday, October 26. This annual lecture honors the contributions of colon and rectal surgeon Herand Abcarian, MD, FACS, FASCRS.

The original framers of the CoC focused on people, purpose, principles, and adaptability to create a strategic yet flexible framework that promotes continuous improvement across cancer care, Dr. Nelson explained.

“Not many things survive 100 years, not even the Fortune 500,” she said. “Only 52 of the original 500 companies reported in 1955 are still members—10 percent—and it’s not been even 100 years. The founders of the Commission on Cancer set such a square and perfect vision and framework for quality care in cancer in 1922 that we are using it to drive improvements today.”

People are key to cancer care, including clinicians, staff, leaders, committee members, and volunteers, Dr. Nelson said. Cancer care revolves around people, from setting standards to research, education, prevention, delivery of care, and monitoring performance.

Purpose is just as important, she continued. Without clear purpose, the best-intentioned people can flounder and work at cross purposes. The CoC has just one purpose: to improve the quality of cancer care.

Principles guide people as they turn purpose into action.

“An important principle in cancer care is reducing suffering, morbidity, and mortality through more organized, systematic application of knowledge that is already available,” Dr. Nelson explained. “New drugs, new trials, new kinds of surgeries are important, but so is application of knowledge, a space we have occupied for a very long time. You can dramatically improve patient outcomes just by moving people to perform according to standards of care and implementation of best practices. The Commission was one of the first organizations in health care to focus on implementation, even though implementation science wasn’t described at the time. Quality improvement is a guiding principle.”

Adaptability helps the CoC remain relevant by incorporating new technologies and approaches. One of the initial six standards was the application of knowledge, better known today as data collection and analysis.

“Peter Drucker pointed out that what you monitor, you improve,” Dr. Nelson said. “And that’s what the Commission has been doing for decades. Monitoring and analyzing translates into patient survival advantage, and it is adaptable over time.”

When paper was the best available method to collect data, the CoC pushed hospitals to create and use standardized forms to collect standardized data across multiple providers. Electronic data collection led to registries spanning multiple hospitals, cancer centers, and geographies.

“Surgeons framed the Commission on Cancer and surgeons have carried that frame forward in ways that didn’t exist 100 years ago,” Dr. Nelson said. “Future generations of surgeons have the opportunity to continue carrying that frame forward in ways we can’t imagine today.”

The Chicago Society of Colon and Rectal Surgery established this lecture to address issues of relevance to the surgical community at-large and focus on emerging issues in the field.

This lecture and other Clinical Congress 2021 sessions are available to registered attendees for on-demand viewing for a full year following Congress on the virtual meeting platform.

For a detailed discussion of this session, view a Clinical Congress Daily Highlights interview with Dr. Nelson conducted by Steven D. Wexner, MD, FACS, Vice-Chair, Board of Regents.