The National Comprehensive Cancer Network (NCCN), American Cancer Society Cancer Action Network (ACS CAN), and National Minority Quality Forum (NMQF) recently presented new ideas for overcoming inequality in oncology. The recommendations—developed by a group of 17 national experts, representing patients and advocates, caregivers, health-care providers, researchers, and industry—directly address how medical systems in the United States often disproportionately fail minority patients, particularly those who are Black and/or Indigenous, and draws on extensive polling data from a recent poll fielded by Public Opinion Strategies on behalf of the organizations to make clear the case for urgent action.
Among the notable survey findings: 63% of Black and 67% of Latinx patients, survivors, and caregivers said they had a negative experience with their oncology care team—such as having assumptions made about them or their financial situation or trouble getting questions answered—in contrast to 43% of White respondents reporting such experiences. As for oncologists, two-thirds of those surveyed believed that non-White patients experienced worse outcomes from cancer care but only one-third believed those patient populations were receiving worse care or poorer communication during care.
Changes in Practice and Policy
To address the inequalities in access to cancer care, the three organizations convened the Elevating Cancer Equity Working Group, whose recommendations include a new Equity Report Card to help providers, payers, and accreditation entities advance the delivery of equitable care. The report card includes 17 measurable practice changes, such as having health systems provide and require annual implicit bias training for all employees, offer culturally and linguistically representative patient navigators or community health workers through internal hiring or contracting with community-based organizations, and offer flexible hours for screening and treatment appointments.
The organizations also created a series of policy change recommendations targeted toward the U.S. Congress, Centers for Medicare and Medicaid Services and commercial payers, federal agencies, and state and local policymakers. Policy examples include measures to remove barriers to clinical trial participation and requiring the U.S. Food and Drug Administration to consider clinical trial diversity as part of a drug approval process, funding public awareness campaigns around cancer prevention that are linguistically and culturally reflective of diverse audiences, and ensuring access to and reimbursement for patient navigators to assist patients with all types of insurance.
