Community Oncology Alliance (COA) Study Validates High Quality Cancer Care in Community Settings

By Marketing

Staff Writer

June 3, 2026 in Education

A comprehensive, real-world study affirms the high quality of cancer care delivered in community settings, with longer survival rates observed for certain metastatic cancers than those reported in industry benchmarks.

Stephen “Fred” Divers, MD

Commissioned by the Community Oncology Alliance and conducted using data from the Flatiron Health Research Network (FHRN), which includes more than 220 sites, the analysis found longer survival rates for patients with newly diagnosed stage IV metastatic breast cancer (mBC) and metastatic non-small cell lung cancer (mNSCLC) compared with national benchmarks.

Unadjusted median survival rates favored the FHRN cohort, with patients with mBC experiencing median survival of 48 months compared with 40 months in benchmark data, and patients with mNSCLC experiencing median survival of 15 months compared with 13 months. Improvements were also observed at one, three and five years. After adjusting for demographic factors, the survival differences widened to 46 months versus 29 months for mBC and 12 months versus 6 months for mNSCLC, underscoring the strength of community oncology care for most U.S. cancer patients.

What follows is a Q&A with Stephen “Fred” Divers, MD, chief medical officer, American Oncology Network (AON), member of the COA Board of Directors, and medical oncologist and hematologist at Genesis Cancer and Blood Institute in Hot Springs, Arkansas. Divers was an instrumental contributor to the COA study.

Q: Describe the parameters of the study.

Researchers examined data from nearly 98,000 patients diagnosed with metastatic NSCLC or metastatic breast cancer between January 2013 and December 2022. All patients received care at community oncology practices participating in the Flatiron Health Research Network (FHRN). Researchers compared outcomes with population-based benchmarks from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, widely considered the gold standard for tracking cancer incidence, prevalence, and mortality in the United States.

The study utilized the Flatiron Health Research Database (FHRD), a longitudinal, deidentified repository derived from electronic health records across more than 220 community oncology practices representing about 40% of U.S. community oncologists. The analysis focused on patients with de novo stage IV metastatic breast cancer or metastatic NSCLC. This approach helped address a known limitation of SEER in reliably capturing cancer recurrences, providing valuable insight into outcomes in community oncology settings while acknowledging some limitations in generalizability.

Q: Were you surprised by the results?

Not at all. We have always known that community oncologists deliver high-quality care, and this study reinforces that point. What surprised me was the magnitude of the difference in median survival compared with the SEER benchmark — 48 months versus 40 months for metastatic breast cancer and 15 months versus 13 months for metastatic non-small cell lung cancer.

Once researchers adjusted for age, sex, race and ethnicity, and cancer subtype, the gap became even larger. That further validated what many of us have observed in practice. The results are truly remarkable.

Q: What does this mean for care access?

Access to care is a significant part of the story. When patients can’t receive treatment close to home, they are less likely to face logistical and financial barriers that can delay or even prevent care. That likely helps explain why treatment initiation rates were higher in the community oncology cohort.

The findings also highlight the value of a personalized, high-touch model of care, where patients can begin treatment sooner and remain more closely connected to their care teams throughout their cancer journey.

Q: What does this mean for patients?

It means patients can receive quality care close to home.

When we presented the results at the COA conference, I shared the story of a patient who compared her experience at a community oncology practice with her late mother’s experience at a large tertiary care center. She described her mother’s care as feeling “cold and sterile,” while she felt completely at ease receiving care in the community setting.

That story speaks volumes. We have long had data demonstrating strong patient experiences and lower costs in community oncology. What has been missing is outcomes data. Having a benchmark such as SEER helps complete the picture and provides additional evidence of the value community oncology delivers.

Q: What comes next?

This project represents the first phase of a multiyear collaboration between COA and Flatiron Health. Researchers are already exploring future analyses that will be conducted independently by Flatiron using its proprietary, carefully curated real-world data from the FHRN.

In addition to metastatic breast and lung cancer, future research may examine other disease areas, the time it takes patients to receive a diagnosis and begin treatment, and additional aspects of community oncology’s patient-centered approach to care.

Any final thoughts?

Survival remains the gold standard for assessing the effectiveness of cancer care, and this research demonstrates community oncology’s ability to deliver high-quality outcomes while providing convenience and personalized care.

Receiving a cancer diagnosis is never easy, but patients can feel confident knowing they can receive exceptional care close to home. These findings reinforce an important message: Patients don’t sacrifice the quality of care by choosing a community oncology practice; in fact, they increase it.