Advocating for Equity in Cancer Care

Authors:
James McCanneyNational Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania;

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 JD
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Terrell JohnsonNational Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania;

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Lindsey A.M. BandiniNational Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania;

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Shonta ChambersPatient Advocate Foundation, Hampton, Virginia; and

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Lynette BonarTuba City Regional Health Care Corporation, Tuba City, Arizona.

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Robert W. CarlsonNational Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania;

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Demographic factors such as race, socioeconomic status, gender identity, area of residence, native language, and cultural barriers have an effect on outcomes in cancer care. To identify unmet needs, challenges, and opportunities in achieving high-quality, patient-centered cancer care for all, NCCN conducted a yearlong environmental scan, which involved stakeholder meetings with patients and patient advocacy groups to discuss these topics. The findings from this scan informed the corresponding NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care, held in Washington, DC, on December 10, 2018. In addition to the many patient advocacy groups, the summit featured a number of other stakeholders that advocate for equity in cancer care. This article encapsulates the findings of the environmental scan and the discussion from the NCCN Patient Advocacy Summit.

Submitted May 28, 20198; accepted for publication July 2, 2019.

Disclosures: The authors have disclosed that they have no financial interests, arrangements, or affiliations with the manufacturers of any products discussed in this article or their competitors.

Correspondence: James McCanney, JD, National Comprehensive Cancer Network, 3025 Chemical Road, Suite 100, Plymouth Meeting, PA 19462. Email: mccanney@nccn.org
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  • 1.

    Horwitz RI. Equity in cancer care and outcomes of treatment: a different type of cancer moonshot. JAMA 2016;315:12311232.

  • 2.

    United States Census Bureau. The American Indian and Alaska Native Population: 2010. Available at: https://www.census.gov/history/pdf/c2010br-10.pdf. Accessed July 22, 2019.

  • 3.

    Horwitz S. U.S. to pay Navajo Nation $554 million in largest settlement with single Indian tribe. The Washington Post. September 24, 2014. Available at: https://www.washingtonpost.com/world/national-security/us-to-pay-navajo-nation-554-million-in-largest-settlement-with-single-indian-tribe/2014/09/24/4dc02cc6-434e-11e4-9a15-137aa0153527_story.html?utm_term=.25d2f1db8e14.

  • 4.

    Bonar L. Overcoming disparities: a case study on the Navajo Nation. Presented at the NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care; December 10, 2018; Washington, DC.

  • 5.

    Hoover J, Gonzales M, Shuey C, et al.. Elevated arsenic and uranium concentrations in unregulated water sources on the Navajo Nation, USA. Expo Health 2017;9:113124.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Ritz B. Radiation exposure and cancer mortality in uranium processing workers. Epidemiology 1999;10:531538.

  • 7.

    Spanne A. Uranium pervades homes on and near Navajo Nation. High Country News. August 27, 2017. Available at: https://www.hcn.org/articles/pollution-epa-budget-cuts-threaten-to-slow-uranium-cleanup-at-navajo-nation. Accessed August 13, 2019.

  • 8.

    Cleaning Up Abandoned Uranium Mines. U.S. Environmental Protection Agency. Available at: https://www.epa.gov/navajo-nation-uranium-cleanup/cleaning-abandoned-uranium-mines. Accessed February 5, 2019.

  • 9.

    Navajo Nation Demographics. Navajo Community Development Financial Institution. Available at: http://navajobusiness.com/fastFacts/Overview.htm. Accessed March 12, 2019.

  • 10.

    Fontenot K, Semega J, Kollar M. Income and Poverty in the United States: 2017. Washington, DC: US Census Bureau; 2018. P60-263.

  • 11.

    Cryer D. A viewpoint on cancer equity from patient advocates. Panel discussion at the NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care; December 10, 2018; Washington, DC.

  • 12.

    Sapienza M. A viewpoint on cancer equity from patient advocates. Panel discussion at the NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care; December 10, 2018; Washington, DC.

  • 13.

    Colorectal cancer screening guidelines. American Cancer Society website. Available at: https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/colorectal-cancer-screening-guidelines.html. Accessed February 14, 2019.

  • 14.

    Dialogues on diversifying clinical trials: successful strategies for engaging women and minorities in clinical trials. Available at: http://www.fda.gov/downloads/ScienceResearch/SpecialTopics/WomensHealthResearch/UCM334959.pdf. Accessed March 1, 2019.

  • 15.

    Smith CE, Fullerton SM, Dookeran KA, et al.. Using genetic technologies to reduce rather than widen, health disparities. Health Aff (Millwood) 2016;35:13671373.

  • 16.

    Scharff DP, Matthews KJ, Jackson P, et al.. More than Tuskegee: understanding mistrust about research participation. J Health Care Poor Underserved 2010;21:879897.

  • 17.

    Foster W. A viewpoint on cancer equity from patient advocates. Panel discussion at the NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care; December 10, 2018; Washington, DC.

  • 18.

    Bonar L. A viewpoint on cancer equity from patient advocates. Panel discussion at the NCCN Policy Summit: Advocating for Equity in Cancer Care; December 10, 2018; Washington, DC.

  • 19.

    Trosman J. “Raising All Boats” with the 4R Oncology Program: improving cancer care for the underserved. Presented at the NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care; December 10, 2019; Washington, DC.

  • 20.

    Weldon CB, Trosman JR, Perez CB, et al.. Results from a pilot of an innovative 4R Cancer Care Delivery Model in early breast cancer: impact on timing and sequencing of guideline recommended care [abstract]. J Clin Oncol 2018;36(Suppl):Abstract 561.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Hack TF, Degner LF, Watson P, et al.. Do patients benefit from participating in medical decision-making? Longitudinal follow-up of women with breast cancer. Psychooncology 2006;15:919.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Dans AM, Dans L, Oxman AD, et al.. Assessing equity in clinical practice guidelines. J Clin Epidemiol 2007;60:540546.

  • 23.

    Penner L, Dovidio J, Gonzalez R, et al.. The effects of oncologist implicit racial bias in racially discordant oncology interactions. J Clin Oncol 2016;34:28742880.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Haider AH, Schneider EB, Kodadek LM, et al.. Emergency department query for patient-centered approaches to sexual orientation and gender identity: the EQUALITY study. JAMA Intern Med 2017;177:819823.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Epstein RM, Duberstein PR, Fenton JJ, et al.. Effect of a patient-centered communication intervention on oncologist-patient communication, quality of life and health care utilization in advanced cancer. JAMA Oncol 2017;3:92100.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Feng Y, Dai W, Li Y, et al.. The effect of marital status by age on patients with colorectal cancer over the past decades: a SEER-based analysis. Intern J of Colorectal Disease 2018;33:10011010.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Chambers S. Identifying and addressing the barriers to equity in oncology. Panel discussion at the NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care; December 10, 2018; Washington, DC.

  • 28.

    Dickson N. Identifying and addressing the barriers to equity in oncology. Panel discussion at the NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care; December 10, 2018; Washington, DC.

  • 29.

    Dwyer-Lindgren L, Bertozzi-Villa A, Stubbs RW, et al.. Inequalities in life expectancy among US counties, 1980 to 2014: temporal trends and key drivers. JAMA Intern Med 2017;177:10031011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    DuBenske LL, Gustafson DH, Shaw BR, et al.. Web-based cancer communication and decision making systems: connecting patients, caregivers, and clinicians for improved health outcomes. Med Decis Making 2010;30:732744.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Mapping Broadband Health in America 2017. Federal Communications Commission. Available at: https://www.fcc.gov/reports-research/maps/connect2health/#ll=40,-95&z=4&t=insights&inb=in_bb_access&inh=in_diabetes_rate&dmf=none&inc=none&slb=90,100&slh=10,22.

  • 32.

    Novel Drug Approvals for 2019. U.S. Food & Drug Administration website. Available at: https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DrugInnovation/ucm629491.htm. Accessed February 6, 2019.

  • 33.

    Chen C, Wong R. Black patients miss out on promising cancer drugs. ProPublica website. Available at: https://www.propublica.org/article/black-patients-miss-out-on-promising-cancer-drugs. Accessed March 8, 2019.

  • 34.

    Cox A, Lucas G, Marcu A, et al.. Cancer survivors’ experience with telehealth: a systemic review and thematic synthesis. J Med Internet Res 2017;19:e11.

  • 35.

    DeVito T, Leavitt J, Saleh N. Key advances in oncology, 2018. Oncology (Willison Park) 2019;33:68.

  • 36.

    Weldon C. Identifying and addressing the barriers to equity in oncology. Panel discussion at the NCCN Patient Advocacy Summit: Advocating for Equity in Cancer Care; December 10, 2018; Washington, DC.

  • 37.

    Morris VK, Salem ME, Nimeiri H, et al.. Nivolumab for previously treated unresectable metastatic anal cancer (NCI9673): a multicentre, single-arm, phase 2 study. Lancet Oncol 2017;18:446453.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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