"The Commission on Cancer (CoC) of the American College of Surgeons (ACoS) submitted quality of care measures for breast and colorectal cancer to the National Quality Forum (NQF) in response to its call for proposed breast measures in late 2004 and colorectal measures in early 2005.  Measures were reviewed by the CoC?s breast and colorectal disease site teams prior to their submission to the NQF for consideration. "

"A NQF Steering Committee for quality of cancer care measures was charged with assuring that pertinent stakeholders had appropriate opportunity review and provide input on the measures under consideration.  Two Technical Panels assembled by the NQF made up of breast and colorectal experts in the areas of surgery, radiotherapy, medical oncology, health care consumers, and health services research provided technical evaluation of the proposed measures.  The NQF Steering Committee and Technical panels reviewed measures using four criteria:"

"Eight measures proposed by the CoC (four breast cancer, three colon cancer, and one rectal cancer) were reviewed by the NQF.  In response to specific comments from the NQF, the CoC examined additional data and made revisions to the originally proposed measures.  Five measures were determined to meet the evaluation criteria established by the NQF and are specified in the following tables."

"Cancer registry data elements are nationally standardized and considered open source.  Each of these measures was developed by the CoC with the expectation that cancer registries would be used to collect the necessary data to assess and monitor concordance with the measures.  Extensive assessment and validation of the measures was performed using cancer registry data reported to the National Cancer Data Base (NCDB)."

"All measures are designed to assess performance at the hospital or systems-level, and are not intended for application to individual physician performance."

", meaning that these measures can be used for such purposes as public reporting, payment incentive programs, and the selection of providers by consumers, health plans, or purchasers.  "

" measures are intended to be used for internal monitoring of performance within an organization or group so that analyses and subsequent remedial actions can be taken, as appropriate. "

" developed a similar set of measures for breast and colorectal cancer.  Facilitated by the NQF, the CoC, ASCO, and NCCN agreed to synchronize their developed measures to ensure that a unified set were put forth to the public. "

"Through a collaborative process, the CoC, ASCO and NCCN have agreed upon common specifications of the measures below."

"Radiation therapy is administered within 1 year (365 days) of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer."

"Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1cN0M0, or Stage II or III hormone receptor negative breast cancer."

"Consideration or administration of multi-agent chemotherapy initiated within 4 months (120 days) of date of diagnosis"

" third generation aromatase inhibitor is considered or administered within 1 year (365 days) of diagnosis for women with AJCC T1cN0M0, or Stage II or III hormone receptor positive breast cancer."

"Adjuvant chemotherapy is considered or administered within 4 months (120 days)  of diagnosis for patients under the age of 80 with AJCC Stage III (lymph node positive) colon cancer."

" for breast and colorectal cancers, released in October 2006 and March 2007 respectively, have demonstrated that improvements in data quality can demonstrate the quality of patient care when the entire cancer committee supports system-level enhancements to ensure complete and precise documentation.  Specifically, the "

" reports provide CoC-Approved Cancer Programs with a preliminary examination of program-specific breast and colorectal cancer care practices and promote quality improvement activities in anticipation of the endorsement by the NQF of the measures documented here."

"The CoC has begun development of reporting templates for each of these measures using data reported by cancer registries from CoC-Approved Cancer Programs.  All three organizations (CoC, ASCO, and NCCN) have agreed that implementation of these measures necessitates reporting concordance rates for administered therapy, considered therapy, and an aggregate rate.  This
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