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Complex and Rare Cancers

Blue Distinction Centers for Complex and Rare Cancers have received their designation based on surgical case volume for adults with certain complex and rare cancers, as well as structure and process criteria. There is evidence supporting that for many complex and rare cancers, higher surgical volume is related to improved patient outcomes. Our first phase of the program assesses facilities on evaluation, treatment planning, complex inpatient care and major surgical treatments; all delivered by multidisciplinary teams with distinguished expertise and subspecialty training for complex and rare cancers.

While this designation is meant as a comprehensive indicator of quality, facilities were required to submit data on each of the individual cancer types as part of the evaluation process. The cancers were split into two groups based on the strength of available evidence and, to a lesser extent, rarity of the cancer type. The cancer types with stronger evidence were weighed more heavily during the evaluation process.

To become a Blue Distinction Center for Complex and Rare Cancers, facilities had to satisfy criteria for at least five of the eight main cancers. The additional cancer types were also evaluated and are intended to be another resource for patients and providers. Each cancer type, regardless of group, had three criteria areas that had to be met for an applicant to satisfy qualifications:

  1. Multidisciplinary treatment team and corresponding sub-specialty training (varied by type)
  2. Regular meetings of sub-specialized, multidisciplinary tumor board/cancer conferences
  3. Minimum annual average surgical case volume

Main cancers used for this designation evaluation:

  • Bladder cancer
  • Brain cancer – primary
  • Esophageal cancer
  • Gastric cancer
  • Liver cancer – primary
  • Pancreatic cancer
  • Rectal cancer
  • Acute leukemia (inpatient, non-surgical)

Additional cancers:

  • Bone cancer – primary
  • Head and neck cancers
  • Ocular melanoma
  • Soft tissue sarcoma
  • Thyroid cancer – medullary or anaplastic

The evidence-based selection criteria for this program were developed in strategic collaboration with the National Comprehensive Cancer Network (NCCN)*, and a panel of expert clinicians.

Blue Cross Blue Shield recognizes that the majority of patients' multidisciplinary treatment may be best accomplished by integrating the expertise available in a Blue Distinction Center with locally available treatment resources, especially for outpatient chemotherapy and radiotherapy, based on individual circumstances and patient preference.

*This organization has provided information and input, but does not formally endorse the Blue Distinction Centers program.