Access to Quality Cancer Care

Quality cancer care requires safety, efficacy, timeliness, and a patient-centered approach coordinated by an interprofessional team with the integration of evidence-based practices to continuously improve care (Institute of Medicine, 2013). Without essential services targeted at reducing cancer risk, morbidity, and mortality, patients may suffer from an increased incidence of cancer, decreased quality of life, or less-than-optimal outcomes. Lack of insurance or inadequate healthcare coverage adversely affects health and cancer care on multiple levels. Uninsured individuals are less likely to receive preventive care or obtain screening, more likely to receive inadequate or delayed treatment, and more likely to die prematurely than those with adequate health insurance coverage.

To ensure quality cancer care, the Oncology Nursing Society (ONS) affirms the essential role of certified oncology nurses on the interprofessional team in the planning and implementation of cancer care and prevention services and as leaders in delivering quality cancer care. Oncology nurse expertise and contributions are evident in their roles in oncology subspecialties of bone marrow transplantation/cellular therapy, medical, radiation, and surgical oncology. ONS affirms the essential role of certified oncology nurses and oncology advanced practice registered nurses (APRNs) in increasing healthcare access, promoting clinical excellence, managing symptoms and adverse events, improving patients’ quality of life, documenting patient outcomes, and increasing the cost effectiveness of care. APRNs have autonomy in their practice as determined by state practice laws and should assume responsibility and accountability for health promotion and maintenance, as well as the assessment, diagnosis, and management of patient problems to the full scope of their practice.

It is the position of ONS that

  • All people should have access to comprehensive, affordable healthcare without discrimination, including populations who are at risk, vulnerable, underserved, or underrepresented.
  • Essential services, provided by certified oncology nurses in all oncology subspecialties, include prevention and risk reduction, screening, early detection, access to clinical trials, and treatment, as well as palliative, psychosocial, survivorship, and end-of-life care.
  • Holistic quality cancer care requires access to healthcare professionals across specialties with an understanding of how cancer and cancer treatments affect physical and psychosocial functioning.
  • Consumers must have access to a full choice of healthcare providers, including APRNs. APRNs are authorized by their state-defined nurse practice acts to work independently or in collaboration with a designated physician partner. As such, reimbursement for care provided by APRNs (CNSs and NPs) should be included in federal, state, third-party, and private payer reimbursement systems. ONS supports full integration of reimbursement for care provided by APRNs across all cancer care settings.

Approved by the ONS Board of Directors, March 2012. Reviewed January 2013, January 2014, January 2015, January 2016, October 2017, March 2019.

Download this position statement.


Institute of Medicine. (2013). Delivering high-quality cancer care: Charting a new course for a system in crisis. Washington, DC: National Academies Press.

ONS Position Statements

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