Clinical Nurse Specialist in Advanced Oncology (AOCNS)


An Advanced Oncology Certified Clinical Nurse Specialist (AOCNS) is an advanced nursing practitioner who participates in the care of patients with advanced forms of cancer. The AOCNS specialist is involved in all aspects of care, from assessment to treatment to management of outcomes.

Credentialing Organization

Oncology Nursing Certification Corporation. You will be required to take an examination, the fee for which will depend on whether you are a member of the Oncology Nursing Society (ONS) or the Association of Pediatric Hematology/Oncology Nurses (APHON). There are discounts available on the exam fee for applicants age 65 and over. Your nursing license number and expiration date as well as information about past nursing experience will be required when applying. Upon passing the examination, you will be given the following credential: Certified Pediatric Hematology Oncology Nurse (CPHON). The certification is valid for a limited number of years and then must be renewed.


Before taking the exam to be certified as an advanced oncology clinical nurse, you'll need:

  • A current license as a registered nurse (RN).
  • A degree in nursing on at least the Master's level from an accredited educational body.
  • 500 or more hours as a clinical nurse specialist in adult oncology nursing supervised by faculty either as part of a graduate educational program or after graduation.

Before renewing your AOCNS certification, you'll need:

  • A current certification, in good standing, as an AOCNS.
  • A current license as an RN with no restrictions.
  • At least 1,000 hours as a clinical nurse specialist in adult oncology. These hours must fall within the four year period prior to applying for renewal.

About the Certification Exam

The exam consists of 165 questions, divided into 11 subject areas representing knowledge essential to advanced practice as a nurse. Of these questions, 125 count toward the final score. (The remainder are questions being statistically tested for inclusion in future exams.) The questions are divided into 11 subjects: Screening, Prevention, Early Detection, and Genetic Risk (4 percent), Diagnosis, Staging, and Treatment Planning (8 percent), Cancer Treatment (16 percent), Side Effect and Symptom Management (18 percent), Oncologic Emergencies (9 percent), Survivorship (6 percent), End of Life Care (7 percent), Psychosocial Issues (10 percent), Coordination of Care (7 percent), Professional Practice (7 percent), and Roles of the Advanced Practice Nurse (8 percent).

CNS Certification Options

Free AOCNS Practice Test

1. Which of the following cancers is the leading killer worldwide?

a. Stomach
b. Lung
c. Colon
d. Liver

2. Cancer incidence is:

a. The same as prevalence
b. The number or percent of people alive in the population who have had a diagnosis of cancer
c. The number of new cancers of a specific site/type in the population during 1 year
d. None of the above

3. Which of the following cancer types has decreased the most in incidence during the previous decade?

a. Prostate
b. Lung
c. Female breast
d. Melanoma

4. Which of the following races has the highest mortality due to cancer?

a. African American
b. Hispanic
c. Caucasian
d. Asians

5. Female breast cancer:

a. Accounts for 30% of all cancer-related deaths among women
b. Will develop in one out of eight or nine women during her lifetime
c. The five-year survival rate is about 50%
d. All of the above

AOCNS Answers and Explanations

1. B: The three leading cancer-related deaths in the global population are due to lung (17.8%), stomach (10.4%), and liver (8.8%). The industrialized countries account for the highest rates while the lowest rates tend to be in northern Africa and southern and eastern Asia. Worldwide cancer rates are expected to increase in the near term because of aging populations and unhealthy lifestyles such as smoking and probably obesity. Tobacco use alone is responsible for 10 million deaths per year and is estimated to double by 2020. Although cancer rates (usually expressed as number per 100,000 population) in the United States have declined somewhat, there has been an increase in lung cancer among women and a general rise in liver cancer.

2. C: Cancer statistics are published annually by the American Cancer Society (ACS) and are expressed as incidence and prevalence. Incidence refers to the number of new cancers of a specific site or type in a population per year. The numbers may refer to a general population or be divided into subgroupsbased on age, geography, gender, ethnicity, socioeconomic group, or other distinguishing categories. Carcinomas in situ (except bladder) and basal and squamous cell skin cancers are usually excluded from the general numbers because of their frequency. The number or percent of people alive on a certain date in the population who have a diagnosis of cancer is referred to as prevalence. This includes new and existing cases. The National Cancer Institute estimate of cancer prevalence in the United States at January 1, 2000 was 9.6 million with average age for men 69 and women 64.

3. A: Overall cancer incidence has declined somewhat in men (1.5%) and has stabilized for women. Prostate cancer has declined the most in recent years; there are about 3% fewer cases per year. The incidence of liver cancer has increased the most, approximately 3.9% per year. Other cancers with reduced rates include Hodgkin lymphoma and leukemia, male lung cancer, and stomach and uterine cancers. Melanomas, kidney, and thyroid have also shown a slightly increased incidence. Do not confuse incidence with survival rates. Cancer survival rates are usually expressed as five-year survival and include persons with disease still getting treatment and those who are alive at 5 years after diagnosis with no evidence of disease (NED). Improvements in the survival rate may reflect better treatments or perhaps earlier diagnosis.

4. A: According to statistics from 1996 to 2000, African American men had the highest cancer mortality, 356.2 per 100,000 population, while women in this group recorded 198.6. Caucasians and then Hispanics were next most frequent, while mortality among Asians was the lowest of the major races, 154.8 for men and 102 for women. The mortality rate among African American men is about 43% higher than that for Caucasians, while for women it is 20% higher in the African American community. Lung and prostate cancers account for much of the increased mortality among the African American population: 27% higher for lung cancer and nearly twice the mortality due to prostate cancer. Interestingly, American Indians and Alaskan natives show a mortality rate lower than that of Caucasians: 172.3 versus 249.5 for men and 115.8 versus 166.9 for women.

5. B: Breast cancer accounts for about one-third of all cancer cases in women and about 15% of cancer-related deaths. Modern statistics indicate that the disease will occur in one out of eight or nine women during her lifetime. The five-year survival among Caucasian women is about 88% for all stages but less among African American women (73%), possibly due to the later diagnosis and more advanced disease among the latter group. Recent data show a small downward trend in the incidence of this disease. Median age of diagnosis in women is 63 years. Male breast cancer is quite rare but does appear to be increasing among men younger than 40. Numerous risk factors for the disease have been identified in women, including increasing age, estrogen treatment, early menarche or late menopause (possibly related to duration of exposure to estrogen), nulliparity, family history of breast cancer, radiation exposure, and genetic factors such as the BRCA1 and BRCA2 genes.


Last Updated: 07/05/2018

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