When Stand Up To Cancer® (SU2C) invited me to chair their Health Equity Committee in 2018, I was motivated by this new committee’s purpose – to increase patient diversity in cancer clinical trials.
Joined by extraordinary committee members with expertise in cancer research and science, we considered how to tackle health equity in the era of precision cancer medicine. Our first goal was to develop the parameters of SU2C’s Health Equity Initiative and establish requirements for SU2C-funded research teams to address recruitment and retention of medically underserved patients in SU2C-funded cancer clinical trials.
Fast forward to January 2020, and we officially announced SU2C’s Health Equity Initiative — unaware that we were on the eve of a global pandemic. As COVID-19 took hold of the nation, longstanding healthcare inequities in this country unfortunately came to light as medically underserved Americans, especially Black Americans, shouldered the burden of the pandemic.
Racial cancer care disparities
This feels too familiar, as the inequities we’ve seen for decades in cancer outcomes are similarly striking and unacceptable.
Cancer clinical trial participation remains lower for minority groups compared to their relative population levels in the United States. According to 2020 data from the FDA, 73 percent of participants are white, 14 percent are Asian, six percent are Hispanic, and five percent are Black. While American Indian and Alaska Native people, Asian Americans, and Hispanic/Latino Americans experience significant health disparities across many forms of cancer, Black Americans face the highest mortality rate of any racial or ethnic group for most major cancers.
One cancer that significantly impacts people of color, where we can make significant individual and public health change, is colorectal cancer. Often overlooked or discovered too late, colorectal cancer incidence and deaths rank highest in Black Americans, closely followed by American Indians and Alaska Natives. Disparity in Hispanic adult screening may explain why they too are often diagnosed with later-stage disease, as compared to white adults.
Moreover, screening rates during the pandemic dropped significantly and the medical community foresees increased colorectal cancer deaths, and patients presenting with advanced disease.
Standing up to cancer
SU2C is taking this head-on. By combining cutting-edge research, advocacy group collaboration, and awareness campaigns among medically underserved communities, we are sending one clear message: colorectal cancer is in many cases preventable, and screening saves lives.
This effort includes funding a dream team of investigators at medical institutions that serve medically underserved communities. By pinpointing local needs and tailored interventions (including free screenings), our dream team will transform participating at-risk communities into “Stand Up To Cancer zones” with high colorectal cancer screening rates.
Our goals for screenings align with the National Colorectal Cancer Roundtable (NCCRT) campaign — “80 Percent In Every Community” — to ensure that at least 80 percent of eligible adults are regularly screened for colorectal cancer. Since this campaign’s launch in 2019, a multi-stakeholder approach has resulted in more than 1,700 organizations focused on a common goal. This is exactly the kind of collaborative and big-picture thinking needed to increase screening and save lives.
Speaking of the NCCRT’s work, when we look at the bigger health equity picture in cancer, we know Stand Up To Cancer is not alone. Significant progress, critical conversations, and important collaborations are happening everywhere, bringing together government agencies, advocacy groups, funding organizations, corporations, industry associations, and academic institutions all across the country. I am encouraged by these efforts and appreciate the sense of urgency and focus on this essential work.
As we navigate the complexities of healthcare inequity, now exacerbated by the global pandemic, we must keep pushing to increase cancer screening, reduce barriers to clinical trials and quality cancer care, and engage stakeholders, including the research community. We are in this for the long haul; it’s a marathon, and we need a multifaceted approach to reach the finish line.
The pandemic may be here longer than we thought, and solving health inequity is an extraordinary challenge for us all. We must remain vigilant in prioritizing access to screening and care for all cancer patients.