The American College of Surgeons’  Commission on Cancer, collaborating with the American Society for Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) has defined what it calls ‘quality of care’ measures for  breast and colorectal cancer.

The Commission  proposed a total of eight hospital-level measures:  four breast cancer, three colon cancer, and one rectal cancer.

Accountability measures were established for public reporting, payment incentive programs, and the selection of providers by consumers, health plans, or purchasers. 

Quality improvement measures are included for hospital performance  monitoring

Surveillance measures were established to monitor patterns and trends of care in order to guide funding/resource allocation

Breast Cancer Measures

  • Radiation therapy is administered within 1 year (365 days) of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer.
  • For women under 70 at  Stage II or III,  combination chemotherapy is considered or administered within 4 months
  • Tamoxifen administered within 1 year of diagnosis for women with Stage II or III hormone receptor positive breast cancer.

Colon Cancer Measures

  • For patients under 80, chemotherapy is considered or administered within 4 months  of diagnosis.
  • At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer.

Rectal Cancer Measures  were developed independently:

  • Radiation therapy is considered or administered within 6 months (180 days)  of diagnosis for patients under the age of 80 of  with clinical or pathologic AJCC T4N0M0 or Stage III receiving surgical resection for rectal cancer.


You can read the full recommendations here:

American College of Surgeons: Cancer Programs: CoC Quality of Care Measures.