ASCO Releases Recommendations For Elimination Of Cancer Care Disparities In The United States

Main Category: Cancer / Oncology
Article Date: 30 Apr 2009 - 6:00 PDT

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Citing stark disparities in access to cancer care and survival between minorities and whites, and between people with and without health insurance, the American Society of Clinical Oncology (ASCO) today released policy recommendations for eliminating cancer care disparities in the United States.

ASCO's "Disparities in Cancer Care" policy statement, published online today in the Journal of Clinical Oncology, recommends several strategies to reduce cancer care disparities in the United States: increasing research into cancer disparities, increasing enrollment of minorities in cancer clinical trials, encouraging greater diversity in the oncology workforce and educating the oncology workforce about cultural issues and disparities, and ensuring equal access to quality health care.

Today, ASCO also is announcing the 2009 recipients of its Diversity in Oncology Initiative awards, a first-of-its kind awards program to diversify the oncology workforce developed with assistance from a grant from Susan G. Komen for the Cure®.

"Decades of investment in cancer research have led to important advances in screening and treatment, and vastly improved cancer survival rates," said ASCO President Richard L. Schilsky, MD. "Yet, there is a profound divide in our nation between those with access to the fruits of this research, and those without. If we are to drive down cancer death rates, this gap must be closed."

A new study also published in JCO today points to the urgent need to better address the needs of minority patients in the United States. The researchers project an increase of 99% in cancer incidence among minorities by 2030, compared to 31% among whites.

Studies show that uninsured Americans are less likely to get cancer screenings, more likely to be diagnosed with advanced stages of cancer, and less likely to survive than individuals with insurance. One in five African-Americans is uninsured, as is one in three Latinos. Studies also show that minority cancer patients, independent of insurance status, experience significantly worse outcomes than their white counterparts.

Statement Calls for Equal Access to Health Care, Measures to Improve Minority Care

ASCO's policy statement makes several broad recommendations to increase access to health care and improve the care of minority patients.

"Only through a combination of efforts - addressing financing and delivery of care, enhancing the number and training of oncologists caring for diverse populations, and strengthening research on health disparities - can we deliver the significant achievements that are critical to improving care for all," said Otis Brawley, MD, co-chair of ASCO's Health Disparities Advisory Group and chief medical officer for the American Cancer Society.

ASCO's policy statement calls for:

- Increasing research on the quality of care provided to minority populations and the factors contributing to poorer-quality care.
- Increasing minority enrollment in clinical trials to answer critical questions about cancer progression and treatment in minority populations.
- Increasing the diversity of the oncology workforce to provide more culturally appropriate care to minority patients, and increasing the number of oncologists who practice in underserved areas.
- Developing policies to guarantee equal access to quality health care, with a special emphasis on increasing insurance coverage and reducing economic barriers to cancer care.

Cancer Incidence to Double Among Minorities by 2030

Cancer incidence among minorities will nearly double in the coming decades, according to an article published today in the Journal of Clinical Oncology. The study, "Future of Cancer Incidence in the United States: Burdens upon an Aging, Changing Nation," underscores the urgency of expanding access to health insurance and improving cancer care for minority patients. The study was conducted by researchers at Lackland Air Force Base and the University of Texas M.D. Anderson Cancer Center and City of Hope Cancer Center in California.

The study projects that the total number of people diagnosed with cancer each year in the United States will increase 45%, from about 1.6 million cases per year in 2010 to 2.3 million cases per year by 2030. Much of this can be attributed to projected increases in the number of minorities and older adults in the United States.

By 2030, the study estimates a 99% rise in cancer incidence for minorities - from 0.33 million to 0.66 million cases annually. In contrast, a 31% increase in cancer incidence is anticipated for non-Hispanic whites. (See complementary fact sheet for details).

"The cancer burden on America is set to increase dramatically, particularly among minorities," Dr. Schilsky said. "This study points to the urgency of eliminating cancer care disparities today, so we can provide life-saving care to the growing numbers of cancer patients that are projected in the coming decades."

"As the make-up of the United States changes over the next 20 years, physician practices will have to adapt," said Benjamin Smith, MD, lead author of the study and chief of radiation oncology at Wilford Hall Medical Center at Lackland Air Force Base in San Antonio, Texas and adjunct assistant professor in The University of Texas M. D. Anderson Cancer Center's Department of Radiation Oncology. "Physicians need to seek out training to enhance their ability to deliver care for minorities and learn how to recognize race- and age-specific differences in cancer progression and cancer treatment."

Diversifying Oncology Workforce Critical to Improving Care for Minorities

ASCO announced today the first recipients of its Diversity in Oncology Initiative, the first program of its kind designed to diversify the oncologist workforce and increase the number of oncologists practicing in medically underserved areas. Currently, 2% of U.S. oncologists are African American and 3% are Latino, compared with 12% and 15% of the U.S. population, respectively.

The initiative is funded through a $350,000 grant from Susan G. Komen for the Cure®.

The grants announced today were awarded in three categories:

- The Loan Repayment Program Award: Three grants of up to $50,000 each for young oncologists who have committed to providing cancer care in a medically underserved region of the United States for at least two years.

- The Medical Student Rotation Award: Four grants of $8,500 each for medical students from populations under-represented in medicine who enter the oncology field. The program allows medical students to participate in 8- to 10-week rotations in oncology. Students are being matched with a mentor oncologist, who will provide ongoing academic and career guidance through the rotation and beyond.

- The Resident Travel Award: Thirteen grants of $1,500 each for medical residents from populations under-represented in medicine to attend ASCO's Annual Meeting (May 29 to June 2 in Orlando, Florida) and be paired with a mentor onsite.

"Susan G. Komen for the Cure is pleased to provide the funding that will enable these talented students and doctors to make a difference in the lives of people with cancer from underserved communities," said Amelie G. Ramirez, DrPH, a member of the Scientific Advisory Board of Susan G. Komen for the Cure and professor of epidemiology and biostatistics at the University of Texas Health Science Center at San Antonio.

Funding for the Diversity in Oncology Initiative will continue in 2010, with additional grant dollars available to fund more students and doctors in each award category.

About ASCO

ASCO is the world's leading professional organization representing physicians who care for people with cancer. With more than 27,000 members, ASCO is committed to improving cancer care through scientific meetings, educational programs and peer-reviewed journals. For ASCO information and resources, visit http://www.asco.org/presscenter. Patient-oriented cancer information is available at http://www.cancer.net.

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ASCO

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