Commission on Cancer (CoC) accreditation is the American College of Surgeons (ACS) review of a hospital or cancer center's cancer program against Optimal Resources for Cancer Care (2020 Standards). This page is for cancer program administrators and cancer committee leaders preparing an initial application, a new service line or a renewal. Integral Healthcare Solutions (IHS) builds your cancer committee's calendar, records and evidence structure; your physicians and registrars own the clinical work.
Last reviewed: October 2026.
What is Commission on Cancer accreditation?
ACS describes the body this way: "The American College of Surgeons Commission on Cancer (CoC) is a consortium of professional organizations dedicated to improving survival and quality of life for patients with cancer." Accredited programs meet "more than 30 standards that help improve the quality of care through cancer-related programs and activities," and "Nearly 1,400 hospitals and cancer centers are accredited by the CoC in the US" (ACS, Commission on Cancer).
The governing text is Optimal Resources for Cancer Care (2020 Standards), effective January 1, 2020. The ACS standards page showed a last-updated date of March 2026 when we read it, and ACS publishes a standards change log from the same page (ACS, CoC Standards and Resources). Read the change log against your copy of the standards before you start. We did not open the change log, so we do not know what the March 2026 update changed.
ACS calls the CoC "a multidisciplinary accreditation program that has developed comprehensive, patient-centered standards for cancer programs." Each program is assigned a category by facility type, structure, services and annual caseload. The categories are Community Cancer Program, Comprehensive Community Cancer Program, Academic Comprehensive Cancer Program, Free-Standing Cancer Center Program, Hospital Associate Cancer Program, Integrated Network Cancer Program, NCI-Designated Comprehensive Cancer Center Program, Pediatric Cancer Program, CoC Pediatric Specialty Accreditation, Rural Cancer Program and Veterans Affairs Cancer Program (ACS, CoC Accreditation).
The application steps, from the ACS apply page:
- "Submit the complete PRQ through QPort at least 60 calendar days before the confirmed site visit date." The PRQ is the Pre-Review Questionnaire.
- "Initial CoC site visits review 1 calendar year (January 1–December 31) of compliance with all standards."
- The program will "Receive the Accreditation Report, which documents results, within 45 days of the site visit or as soon as practical thereafter."
- "When accredited, the accreditation term is 3 years from the date of the initial site visit" (ACS, Apply for CoC Accreditation).
Who needs it and what triggers it
The buyer is a hospital, cancer center or network whose cancer program leaders want ACS review of the program. The work usually starts with one of these events:
- A first application. The ACS apply page sets the cancer registry start date by site-visit year: no later than January 1, 2024 for 2026 visits and no later than January 1, 2025 for 2027 visits. Check the apply page for your own visit year (ACS, Apply for CoC Accreditation).
- A breast program that wants NAPBC. ACS requires NAPBC applicants to be accredited by the Commission on Cancer "if applying in 2026 or beyond"; see NAPBC breast center accreditation readiness.
- Renewal. The accreditation term is 3 years from the initial site visit, so an accredited program prepares again before it ends.
- A new service line or structure. Because the category depends on facility type, structure, services and caseload, a change in any of them is a reason to check which category applies.
How IHS helps
IHS works from the Optimal Resources for Cancer Care standards your program obtains from ACS. The process:
- Gap assessment. Each standard is read against what your cancer program does and documents today, and each gap is written down with the standard it comes from.
- Questionnaires and evidence mapping. IHS sends questionnaires on the cancer committee, annual reviews and service coordination, then builds a crosswalk from each standard to its evidence and the person who owns it.
- Drafting. IHS drafts the cancer committee calendar, annual-review templates, coordination records and a submission structure for the PRQ. Your cancer committee reviews and approves each document, and your program submits the PRQ.
- Mock review. Before the site visit, IHS reviews the assembled evidence against the standards as a reviewer would and lists what is missing or thin.
- Readiness support. If the visit finds non-compliant standards, IHS drafts responses for your program to submit.
What you supply: the standards, committee minutes, registry data, and the cancer committee's clinical decisions.
The limit: registry abstraction, clinical quality studies and outcome interpretation need cancer registrars and physicians, and IHS does not do them. IHS describes its process here and does not claim prior ACS engagements. Your program applies, submits and corresponds with ACS; IHS drafts, and you submit.
What to have ready
Each item below comes from the ACS CoC accreditation and apply pages, which govern applications under Optimal Resources for Cancer Care (2020 Standards), read October 2026.
- Your copy of Optimal Resources for Cancer Care (2020 Standards) and the change log ACS publishes with it (ACS, CoC Standards and Resources).
- A working view of your program category, based on the facility type, structure, services and annual caseload ACS uses to assign one (ACS, CoC Accreditation).
- Your cancer registry start date. The ACS apply page sets the cancer registry start date by site-visit year: no later than January 1, 2024 for 2026 visits and no later than January 1, 2025 for 2027 visits. Check the apply page for your own visit year (ACS, Apply for CoC Accreditation).
- Records covering one full calendar year, since "Initial CoC site visits review 1 calendar year (January 1–December 31) of compliance with all standards" (same page).
- Access to QPort and a PRQ calendar that finishes "at least 60 calendar days before the confirmed site visit date" (same page).
- A list of any standard you expect to miss, since "Programs undergoing an initial site review that have five or more non-compliant standards will be rated Not Accredited" (same page).
- Cancer committee minutes and annual-review records for the review year, with the physicians and registrars who own them named.
The introductory call is the place to walk through this list against your own program.
How it compares
| Route | What it covers | Basis |
|---|---|---|
| CoC accreditation | The whole cancer program, reviewed against Optimal Resources for Cancer Care; 3-year term | ACS, Apply for CoC Accreditation |
| NCI Cancer Center designation | A designation from the National Cancer Institute. CoC has its own category for NCI-Designated Comprehensive Cancer Center Programs. We did not review NCI's criteria for this page. | ACS, CoC Accreditation |
| Site-specific ACS programs | The National Accreditation Program for Breast Centers and the National Accreditation Program for Rectal Cancer cover one disease site; NAPBC requires CoC accreditation for 2026 and later applicants | ACS, quality programs index |
| No accreditation | No ACS review of the cancer program | None |
The table describes scope only. Which route fits depends on your program's goals, structure and services.
What it costs
ACS states: "ACS Cancer Programs annual accreditation fees have been adjusted for 2026. The new fee amounts will go into effect for subscriptions beginning or renewing on or after January 1, 2026." It adds that "the 2026 fee chart is available in the resources section of QPort" (ACS Cancer Programs News). The apply page refers to an accreditation fee invoice issued after application. Verify current fees with ACS.
ACS does not publish CoC fee amounts on the public pages we reviewed. IHS prices its own work after a free introductory call.
What this is not
- IHS is not ACS and does not grant, influence or predict an accreditation decision.
- IHS does not apply to, submit to or correspond with ACS for your program. Your program does.
- IHS does not abstract registry data, run clinical quality studies or interpret outcomes. Your registrars and physicians do.
Frequently asked questions
What is Commission on Cancer accreditation?
It is the American College of Surgeons review of a cancer program. ACS calls the CoC "a multidisciplinary accreditation program that has developed comprehensive, patient-centered standards for cancer programs" (ACS, CoC Accreditation). Programs are reviewed against Optimal Resources for Cancer Care (2020 Standards).
Which CoC program category fits our hospital?
ACS assigns the category by facility type, structure, services and annual caseload. Categories include Community Cancer Program, Comprehensive Community Cancer Program, Academic Comprehensive Cancer Program, Integrated Network Cancer Program and Rural Cancer Program, among others (ACS, CoC Accreditation).
How much registry data do we need before applying for CoC accreditation?
The ACS apply page sets the cancer registry start date by site-visit year: no later than January 1, 2024 for 2026 visits and no later than January 1, 2025 for 2027 visits. Check the apply page for your own visit year (ACS, Apply for CoC Accreditation).
What is the CoC Pre-Review Questionnaire (PRQ) and when is it due?
The PRQ is the questionnaire a program completes before its site visit. ACS requires programs to "Submit the complete PRQ through QPort at least 60 calendar days before the confirmed site visit date" (ACS, Apply for CoC Accreditation).
What period does the initial CoC site visit review?
One calendar year. "Initial CoC site visits review 1 calendar year (January 1–December 31) of compliance with all standards." The program receives the Accreditation Report "within 45 days of the site visit or as soon as practical thereafter" (ACS, Apply for CoC Accreditation).
How many non-compliant standards cause a program to fail initial CoC accreditation?
Five or more. "Programs undergoing an initial site review that have five or more non-compliant standards will be rated Not Accredited and will need to reapply for accreditation after one calendar year" (ACS, Apply for CoC Accreditation).
How much does Commission on Cancer accreditation cost?
ACS does not publish the amounts on its public pages we reviewed. It adjusted cancer program annual accreditation fees for 2026, and "the 2026 fee chart is available in the resources section of QPort" (ACS Cancer Programs News). Verify current fees with ACS.
How long does CoC accreditation last?
"When accredited, the accreditation term is 3 years from the date of the initial site visit" (ACS, Apply for CoC Accreditation).
How many programs hold CoC accreditation?
ACS states that "Nearly 1,400 hospitals and cancer centers are accredited by the CoC in the US" (ACS, Commission on Cancer).