The ACR was one of the six organizations that founded the American Joint Committee on Cancer (AJCC) in 1959, along with the American College of Surgeons (ACoS), the College of American Pathologists (CAP), the American College of Physicians (ACP), the American Cancer Society (ACS), and the National Cancer Institute (NCI). The long standing commitment between the AJCC and the ACoS Commission on Cancer (CoC), and the ACR’s direct interest in collaborating with sister organizations, drive the ACR’s participation in CoC activities.
A Longstanding Commitment to Care
The ACR’s own medical imaging accreditation efforts date to 1987, when ACR radiologists and medical physicists on the ACR’s Breast Task Force developed the Mammography Accreditation Program to address documented concerns about inadequate quality mammography in the U.S. Since then, the ACR has accredited more than 39,000 facilities across the full spectrum of diagnostic and therapeutic radiologic modalities.
“The longstanding commitment of the ACR to the development of quality standards in radiologic practice and their application through the accreditation process dovetails perfectly with the efforts of the CoC’s accreditation programs,” says Alan C. Hartford, MD, PhD, FACR, president-elect of the ACR Council of Affiliated Regional Radiation Oncology Societies. “Quality metrics for diagnostic imaging and radiation therapy must be fundamental to the CoC’s development of quality standards in cancer diagnosis and treatment. Given its longstanding traditions within the CoC and its many years of organizational experience, the ACR’s quality standards and accreditation activities are a natural bedrock for the CoC’s efforts in quality assessment and improvement.”
According to Alda L. Tam, MD, a member of the ACR Commission on Interventional and Cardiovascular Imaging, IRs interface with patients at multiple time points during their cancer journey: acquiring tissue through biopsy for diagnosis, offering personalized procedural care and therapy for tumor control, and providing symptomatic relief at the end of the life. “Frequently, IRs are able to offer minimally invasive image-guided treatment options to cancer patients who otherwise would not be operative candidates,” says Tam. “As the incoming ACR representative to the CoC, I’m excited to share this perspective as an additional dimension of radiology’s commitment to and delivery of high-quality cancer care.”
An Advocate for Screening
Mounting evidence suggests that COVID-19 will be an endemic virus that will continue to shape healthcare delivery for the foreseeable future. In this context, cancer care has suffered, especially for underserved and underrepresented populations. Studies from the U.S. and Europe have shown that cancer screening dropped dramatically during the pandemic, which may worsen preexisting disparities.1
In March 2021, the U.S. Preventive Services Task Force (USPSTF) updated its lung cancer screening guidelines to widen screening eligibility for individuals 50 to 80 years of age and who have a 20 pack-year or more smoking history (either currently or have quit in the last 15 years). This update is projected to double the number of individuals eligible for screening and to help reach Black patients who have a higher risk of lung cancer at a younger age and with a lower smoking history.2 “Thanks to updated screening guidelines, advancements in staging, surgical techniques, and biomarker-based targeted therapy, the face of lung cancer is changing from one of doom to one of hope,” says Ella A. Kazerooni, MD, MS, FACR, chair of the ACR Lung-RADS Committee and Lung Cancer Screening Registry®.
It is also well-known that Black patients fare worse in multiple phases of the colorectal cancer continuum — they are less likely to be screened with colonoscopy, are more likely to present with late-disease stages, and have lower five-year rates of survival following a diagnosis, despite adjustments for disease stage at presentation.3 That’s why the new USPSTF recommendation for adults ages 45–49 means that millions more Americans will receive private insurance coverage for this vital screening.4
Finally, new evidence continues to support annual breast cancer screening starting at age 40, with closer attention given to minority women in underserved populations.5 According to Stamatia V. Destounis, MD, FACR, chief of the ACR Commission on Breast Imaging, “Mounting data and more inclusive screening recommendations should remove any thought that regular screening is controversial.”