NcXHF

MAYER ET AL
FIGURE 2. (A) Infertility Risks Discussed before Chemotherapy (181 Practices); (B) Fertility Preservation
Options Discussed or Referral to Specialist (181 Practices)
cords. The selected QOPI survivorship measures to assess
physician adherence to these guideline recommendations are
discussed below.
Treatment Summary
The development and implementation of the SCP has been
described earlier in this article, and the QOPI effort to document
uptake of this recommendation to provide a treatment
summary within 3 months of completing treatment is documented
in Fig. 1. The percentage of physician practices in
which a treatment summary is documented decreased from
35% in 2009% to 20% in 2014. However, recent initiatives to
simplify the ASCO SCP, along with extensive efforts to assure
integration of the SCP with electronic medical records, and
the requirement of the CoC that by January 2019 all individuals
receive an SCP should begin to reverse this decreasing
trend. 7 However, to be successful, the barriers previously described
will need to be addressed.
Tobacco Cessation
In 2003, ASCO released a policy statement on tobacco cessation,
32 and an update was published in 2013. 26 A cornerstone
of this policy is that every individual should be queried about
smoking status, and appropriate interventions and referrals
to smoking cessation programs should be undertaken. There
were consistently 81% to 84% of medical records that documented
a smoking/tobacco cessation discussion in the years
2009 to 2014. Although guideline adherence is consistently
greater than 80%, one wonders whether that goal should be
higher.
Risk of Infertility
The ASCO clinical practice guideline on fertility preservation
was published in 2006 and recently was updated in 2013. 27
Among the key recommendations were to discuss fertility
preservation with all individuals of reproductive age and to
refer those interested in fertility preservation to reproductive
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