PURPOSE A cancer service line (CSL) in academic medical centers provides a patient-centered approach aimed at enhancing the patient experience and clinical outcomes, managing financial operations, increasing access to clinical research, and reducing health disparities. In 2023, the Association of American Cancer Institutes (AACI) Physician Clinical Leadership Initiative (PCLI) Steering Committee conducted a survey to evaluate the current state of CSLs with respect to governance, leadership, organizational, and financial structure and function. METHODS The survey was electronically sent to cancer center directors and administrative directors at 107 of AACI's 108-member cancer centers, achieving a response rate of 70%. Survey participation was voluntary, and no compensation was provided. RESULTS Fifty-eight (77%) of the 75 survey respondents (which included 40 National Cancer Institute–designated cancer centers) had a defined CSL with only 35 (60%) using a formal charter. All CSL leadership teams included physician leaders, and 44 (76%) centers included their cancer center director within this leadership. More than 28 key services were identified as parts of the CSL structures. Most respondents reported that strategic planning (88%), quality and safety (83%), and regional alignment (78%) were key responsibilities. Twenty-six (45%) centers reported a policy defining a funds flow from the health system to the cancer center. Performance assessment for the CSLs included metrics related to growth and finance, access and services, quality and outcomes, and academics. CONCLUSION These results demonstrate the diverse nature of CSLs across academic medical systems within the United States. Furthermore, given the complexity faced by academic cancer centers in establishing and expanding their CSLs, AACI remains committed to working closely with its members to identify best practices focused on innovative and value-based cancer care.
Fracasso et al. (2025) studied this question.