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Conference Coverage

Addressing Disparities in Cancer Health, Equity, and Outcomes

Marta Rybczynski

A panel at the 2022 Community Oncology Conference discussed programs that can address disparities in cancer care and access to cancer care.

Nicolas Ferreyros, Managing Director, Policy, Advocacy & Communications, Community Oncology Alliance (COA), Moderator, explained that COA takes a multifaceted approach to addressing disparities, looking at screening, pilot programs, research, and provider education.

Mr Ferreyros explained that COA began a “time to screen” initiative to address the issue of low screening rates in oncology. “The reason we got into this time to screen initiative was because when the pandemic hit, screening rates cratered, and now we are working on ways to get back on track” he said, adding, “Rates are currently recovering, but recovering unequally.” 

Susan Sabo-Wagner, RN, BSN, OCN, is the Clinical Director of a program called Oncology Consultants Supplies, which provides program resources to patients right off the bat, and push for treatment adherence among patients with cancer. It also uses AI data as a predictive tool for health care providers. 

Kashyap Patel, MD, Chief Executive Officer, Carolina Blood & CancerCare Associates, President, Community Oncology Alliance discussed a program called “No One Left Alone (NOLA),” which aims to understand what causes disparities. It examines access to care, access to biomarker testing, cancer screening, and access to clinical trials. The organization hired a team of three people whose role in the program is to find foundations and resources for patients diagnosed with cancer. NOLA addressed access to biomarker testing by teaming up with two lab partners to ensure that patients have access to biomarker testing, regardless of the financial constraints of getting tested. Following this partnership, testing rates at NOLA increased from 37% to 85%. 

Dr Patel believes that small community practices can create and implement guidelines within their practice in order to address cancer and disparities. 

Patricia J. Goldsmith, Chief Executive Officer, CancerCare, stressed the importance of funding these programs, saying, “We’re going to have to demonstrate results in small but very impactful ways, and then replicate those through partnerships with organizations.” 

Ms Sabo-Wagner noted that these programs have faced dilemmas from a technology standpoint; however, technology partners have assisted in collecting data on patients, which has helped these programs further understand their patients. 

Since these programs began to collect data, they learned that 20% of patients say they may not have food or money for the next month. Dr Patel’s practice partnered with an organization that helps uninsured patients receive blood tests, scans, and other services. The panel emphasize the importance of recognizing the patient outside of their disease and insurance, with respect to their living circumstances. 

The panel also discussed the language barriers that appear within the cancer care space. COA has addressed language inequity by doing “time to screen” awareness campaigns in multiple languages in order to expand their outreach. The Cancer Care Hopeline has language services available to patients when they call. These programs have seen a substantial uptake in the usage of language services since their launch, providing insight for uncertainties about screening qualifications among patients. The Cancer Care Hopeline language services provide information about low-cost or no-cost screening in multiple languages and assist patients with scheduling appointments. 

Ms Sabo-Wagner’s Hope Initiative aims to combat implicit bias among providers. At Cancer Care, there are oncology-trained social workers whose role is to listen to the challenges and issues from patients and their caregivers directly and provide Cancer Care leadership with guidance on how to improve patient experience and patient support. 

Clinical trial diversity is critical because the reality is that the trials should reflect the diversity of the patients. “Pharma has both the obligation and the responsibility to ensure that you include appropriate diversity and put in the resources to help practices to bring trials,” said Dr Patel, adding, “The typical cost of a trial in the ‘ivory towers’ is about six figures, but when they come to us [small practices], we are probably about a fourth of that.” Smaller practices do not have resources internally to spare for trials. “We are willing to put in our personal time, if you [pharmaceutical companies] are willing to work with us,” concluded Dr Patel. 

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