PHILADELPHIA — Leading national cancer organizations have released a joint position statement to guide the future of cancer health disparities research. The statement represents a unified strategy by the American Association for Cancer Research (AACR), the American Cancer Society (ACS), the American Society of Clinical Oncology (ASCO), and the National Cancer Institute (NCI) to foster cooperation across the cancer research community to ensure that all patients – regardless of social demographics, socioeconomic status, or the communities in which they live – benefit from cancer research.
“The AACR is committed to eliminating cancer health disparities, and we hope that the recommendations put forward through this unprecedented collaboration will promote cooperation among all stakeholders in the cancer disparities research community to ensure that research-driven advances benefit all patients, regardless of their race, ethnicity, age, gender, socioeconomic status, and community in which they live,” said Margaret Foti, PhD, MD (hc), chief executive officer of the AACR.
According to the statement, cancer health disparities are pronounced and well documented. Medically underserved populations, including racial and ethnic minorities and individuals of lower socioeconomic status, experience worse cancer outcomes. As the organizations discuss, disparities are driven by a range of multilevel patient, community, and structural factors, including sociodemographics, health care access, lifestyle factors, and biological and genetic differences. While understanding of underlying causes of cancer disparities is growing, emerging and increasing cancer disparities among some populations continue to create new challenges – requiring a deeper understanding of the multilevel, interrelated causes and how to effectively address them, according to the organizations.
The position statement was developed following a summit held by the groups, which brought together experts in clinical cancer research, epidemiology, public health, and health care policy, as well as patient advocates, to discuss the current state of cancer health disparities research and identify top priorities in the field.
Research Needs and Priorities
The joint statement, published simultaneously today by the four co-authoring organizations, outlines the following top research needs and priorities:
Defining and improving data measures and tools for cancer disparities research: Patient data are often incomplete, inaccurate, or overly-simplified and usually do not consider many social and community factors. Cancer disparities research is limited by a lack of comprehensive, consistent data on factors that impact disparities in cancer care and patient outcomes, including a patient’s social status and demographics, community and lifestyle factors, and biology and genetics, as well as by widespread variation in data collection methodology.
Addressing disparities in cancer incidence: Eliminating disparities in cancer incidence requires advancing knowledge of biological and environmental determinants of cancer incidence disparities, including a greater understanding of the role of genetics in contributing to higher cancer risk among certain populations.
Addressing cancer survival disparities: Currently, the interplay between system-level, biological, social, and environmental factors is often inadequately accounted for in cancer research. Counteracting growing disparities in cancer survival requires a more complete picture of the range of factors involved and how to track, identify, and address them.
Improving community engagement in cancer research: Poor translation of innovation in cancer care into health care systems in diverse communities has hampered the impact of innovative treatments and precision medicine advances on underserved patient populations. Ensuring that all patient populations benefit from advances in cancer care requires stronger community engagement in cancer research.
Redesigning cancer clinical trials to acknowledge and address cancer disparities: Recruitment and retention rates in cancer clinical trials are lower for some patient populations. Since clinical trials are the foremost means of generating reliable evidence on efficacy of treatments and patient care methods, changes to the clinical trials system are needed to improve the generalizability and applicability of clinical trial findings and better inform the care of underrepresented patient groups.
The statement provides a series of recommendations to address each of these outlined needs, with a particular focus on guiding investments in cancer health disparities research. In addition to specific recommendations in each of these areas, the statement also includes broad action items that can be taken to further the field of cancer research disparities as a whole, based on the current landscape and existing priorities.
- Investigators, research sponsors, and research publications should insist on the use of the highest-quality data measurement tools and the most granular data for conducting cancer disparities research.
- Establishment of a health disparities research network and multiple consortia to gather relevant patient contextual data and biospecimens are needed to effectively inform cancer disparities research that examines the multilevel factors involved in causing cancer disparities.
- Best practice strategies should be designed and utilized to engage underserved populations in research studies and ensure they are informed of clinical trial opportunities.
- Researchers should be adequately trained in community engagement research tactics, and academic promotions should appropriately account for time needed to conduct community engagement research. Expectations for the possible need for funding beyond funding cycles should be made for community engagement research.
- Cancer treatment systems should ensure real-time monitoring of patient experiences to understand how patients are being treated and intervene when care and outcomes disparities are identified.
“Charting the Future of Cancer Health Disparities Research: A Position Statement from the American Association for Cancer Research, the American Cancer Society, the American Society of Clinical Oncology, and the National Cancer Institute,” was published July 24 in Cancer Research.