A survey of cancer affiliate network hubs in the US: goals, composition, resources, and evaluation

Community hospitals play a critical role in cancer care delivery across the US but face challenges in providing needed services and specialized expertise. Cancer affiliate networks, i.e., formal/informal relationships between a large cancer center (hub) and community cancer centers (affiliates), can potentially improve quality in small hospitals where many Americans receive care. However, published descriptions of these networks are lacking. Thus, we aimed to identify and describe cancer networks across the US.

We assembled a listing of US-based cancer affiliate networks using a formal web searching strategy and surveyed hub representatives regarding network goals, composition, services/resources, and methods for evaluating success.

Sixteen of 21 identified networks responded to the survey. All networks focused on improving access/delivery of high-quality cancer care at affiliate sites with common goals that included improving access to services, supporting quality improvement, and recruitment for clinical trials. Networks often included multiple healthcare systems; few had financial ownership over affiliates; and most had participation requirements (e.g., accreditation). Hubs extended a variety of specialized services/resources to affiliates (e.g., clinical trials, genetic counseling, virtual tumor boards). Approaches to evaluation and quality improvement varied.

We found that cancer affiliate networks generally aimed to improve access and delivery of high-quality cancer care, with considerable variation in the activities used to achieve and evaluate progress toward these goals. As networks continue to operate and emerge, research is needed to identify best practices for optimizing networks' influence on the quality of care in resource-constrained hospitals and enabling effective scaling of the cancer affiliate network model.