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Improving Appropriate Screening for Second Primary Malignancies for Cancer Survivors

This performance improvement module is intended for health care providers, including physicians, physician assistants and nurse practitioners who provide primary care or long-term cancer care for adult patients.

Cancer survivors are estimated to be at approximately 14% increased risk of developing a second malignancy. Approximately 10% of all cancers diagnosed in the US are second primary malignancies. Therefore, cancer screening is an essential component in providing survivorship care.

Performance improvement activity description

The goals of this activity are to improve survivorship care by ensuring that:
  1. Provide appropriate cancer screening for patients with a history of colorectal, prostate or breast cancer and
  2. Provide appropriate cancer screening for patients with a known genetic conditions (i.e. HNPCC or BRCA mutation)

Participant requirements

  1. This activity is available to physicians, physician assistants, and advance practice nurses who provide care to patients with a history of cancer.
  2. Participants must actively implement interventions intended to improve patient care
  3. Participants must review project data that reflects care they have provided
  4. Participants must demonstrative active collaboration in the implementation of the activity (e.g. participating in team meetings, implementing training, analyzing data, etc.

This activity involves a review of patients with a prior diagnosis of colorectal, prostate or breast cancer who are no longer receiving primary cancer treatment to ensure appropriate survivorship care regarding screening for second primaries by the primary care provider. The audit will consist of a minimum of 10 charts. Data will be reviewed to verify compliance with clinical guidelines regarding survivorship care as provided in the National Comprehensive Cancer Network clinical guidelines.

Participants will be provided their results as well as comparison data of peers and benchmarks, when available. Participants will then be asked to identify one or more target areas of improvement and identify strategies for sustained change in their practice. Participants are required to be actively engaged in the improvement activity. After 3-12 months, participants will review a minimum of 10 charts of patients seen during this period and collect new cancer screening data. A report of compliance with clinical guidelines will again be provided.

Patient inclusion criteria

  1. Patients with a prior history of colorectal, breast or prostate cancer.
  2. Patient should not be receiving anti-cancer therapy (surgery, radiation therapy or chemotherapy) at the time of the visit. This excludes hormonal therapy such as leuprolide, tamoxifen or aromotase inhibitors. Patients receiving hormonal agents may be included.

Performance Improvement Credit

20.00 AMA PRA Category 1 CreditsTM provided by the University of Texas MD Anderson Cancer Center.

Stage A5 hrs
Stage B5 hrs
Stage C5 hrs
Total20 hrs *

* For those completing the entire PI Module, an additional 5 hrs of credit will be awarded.

This activity has been approved by the American Board of Family Medicine for Maintenance of Certification for Family Physicians Part IV credit. Term of approval is for two years beginning May 28, 2013, with the option for yearly renewal thereafter.



For further information or assistance, to provide feedback on this web site, or to request a specific professional oncology education topic, please e-mail Professional Oncology Education.

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© 2015 The University of Texas MD Anderson Cancer Center