Multiple studies have shown that adherence to guidelines such as the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) improves various cancer care outcomes, including overall survival and quality-of-life measures. 1–6 However, research also shows dramatic racial disparities in access to guideline-adherent cancer care—particularly between Black and White patients—although significant cancer disparities also exist in the delivery of care to indigenous and Hispanic communities. 7,8 Many oncologists, patients, and caregivers recognize these racial disparities, but the resulting gaps in care equity are not being sufficiently addressed. A keynote session at the NCCN 2021 Virtual Annual Conference discussed a joint initiative that is working to address these gaps.
The Elevating Cancer Equity (ECE) initiative is a collaborative program convened by the American Cancer Society Cancer Action Network, NCCN, and the National Minority Quality Forum. These organizations are united around similar missions to reduce cancer burden and improve the quality and accessibility of care, said Alyssa A. Schatz, MSW, Senior Director of Policy and Advocacy at NCCN and moderator of the session.
The root causes of racial disparities in oncology care are complex and include socioeconomic factors, social determinants of health, and discrimination in care delivery. The ECE initiative aims to better understand these root causes but also to move from discussion to action on these issues. They plan to do this through actionable policy and practice change recommendations, developed by a working group of national experts and informed by survey results from patients, caregivers, and oncologists.
“It’s unsurprising that disparities and access to appropriate treatment have a real impact on care outcomes,” said Ms. Schatz. “Black Americans have the highest death rate and the shortest survival of any racial or ethnic group in the United States, and studies have found that people of color are less likely to be prescribed appropriate pain management, which we know impacts quality of life.”
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Mearis M Shega JW Knoebel RW Does adherence to National Comprehensive Cancer Network guidelines improve pain-related outcomes? An evaluation of inpatient cancer pain management at an academic medical center. J Pain Symptom Manage 2013; 48: 451– 458.
Schwam ZG , Sosa JA , Roman S , Judson BL . Receipt of care discordant with practice guidelines is associated with compromised overall survival in nasopharyngeal carcinoma. Clin Oncol (R Coll Radiol) 2016;28:402–409.
Lumpkins CY , Philp A , Nelson KL . A road map for the future: an exploration of attitudes, perceptions, and beliefs among African Americans to tailor health promotion of cancer-related genetic counseling and testing. J Genet Couns 2020;29:518–529.
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Lumpkins CY Philp A Nelson KL A road map for the future: an exploration of attitudes, perceptions, and beliefs among African Americans to tailor health promotion of cancer-related genetic counseling and testing. J Genet Couns 2020; 29: 518– 529. 32291871
Meghani SH , Byun E , Gallagher RM . Time to take stock: a meta-analysis and systematic review of analgesic treatment disparities for pain in the United States. Pain Med 2012;13:150–174.