In a panel discussion this week, five leaders in oncology proposed an action plan for tackling cancer health disparities and enhancing health equity.

The panel, “Health Equity: Advocacy and access,” hosted by the Cancer History Project May 9, included:

Karen Knudsen, MBA, PhD, CEO, American Cancer Society and the American Cancer Society Cancer Action Network, who moderated the event

Clifford A. Hudis, MD, CEO, American Society of Clinical Oncology; Executive vice chair, Conquer Cancer Foundation; Chair, CancerLinQ

Chanita Hughes Halbert, PhD, Vice chair for research, professor, Department of Population and Public Health Sciences; Associate director for cancer equity, Norris Comprehensive Cancer Center, University of Southern California

Amy E. Leader, DrPH, MPH, Associate professor of population science and medical oncology, associate director of community integration, Sidney Kimmel Cancer Center; Public health teaching faculty, College of Population Health, Thomas Jefferson University

Cheryl Willman, MD, Executive director, Mayo Clinic Cancer Programs (nationally and globally); Director, Mayo Clinic Comprehensive Cancer Center

A recording of this panel is available as a [LINK]video and [LINK]podcast. The full transcript can be found here.

Knudsen challenged the panelists to give examples of programs that have worked to further health equity at their organizations.

“Our health system did COVID vaccines in South Philly taco shops. I mean, why do you need to go into a hospital to get a COVID vaccine?” Leader said. “We are doing smoking cessation in churches, and the DMV, and all of the places that people go Monday to Friday and evenings and weekends, and parks, and not expecting anyone really to come to us, because who has the time or the interest when you’re doing so many things.”

Similarly, Willman described Mayo’s efforts to bring cancer care to the patient. Mayo has been providing follow-up care in the home for 1,500 patients in Florida.

This resulted in “dramatic reduction in hospitalization, dramatic reduction in the disruption and financial strains on families—and patients loved it, to be able to do care in their home environment,” Willman said.

“If we really show that we can deliver that advanced care at home, I think it cements and creates the foundation for us to do clinical trials in the home environment,” Willman said. “Many patients tell us they just can’t disrupt their life to come back and forth and back and forth to a facility for trials. I really believe we’re facing a revolution in how we deliver cancer care.”

Hughes-Halbert pointed to the importance of lay navigation for clinical trials. Data help identify those in need of patient navigation, she said.

“One of the things I’m really excited about, thinking about where we are, are the opportunities to use data-driven strategies to identify patients who would have the greatest level of need for patient navigation, particularly navigation to address social determinants of health,” she said. “Hearing about the opportunities for delivering at-home patient care could be informed using data-driven approaches.”

Hudis said ensuring that patients receive the same access to care begins with policy.

“If you don’t have coverage for clinical trials for that population, then you have an impediment to enrollment,” he said. “The downstream impact of that observed by all of us for years, was a reduced number of Black Americans and other groups on clinical research trials, which in turn raises challenges about interpreting the data at times and applying it to diverse populations.”

Ensuring that Medicaid covers the routine care of clinical research trials helps lower overall mortality, studies have found (The Cancer Letter, June 5, 2020).

“With that, the Clinical Treatment Act was passed at the end of 2021,” Hudis said. “Now, we’ve pivoted to enforcement at the state level, which again will require plenty of work, but it’s a concrete success. I expect it to have a pretty rapid impact on who gets onto clinical trials, which is one narrow part of the funnel if you think about all of the work we’re doing.”

Knudsen challenged the group to propose guidance for the updated Moonshot. The panelists proposed community advisory boards, enhanced digital literacy, and a requirement to screen patients for clinical trial enrollment.

“I think that’s critically important, because in some of the work that I did at my previous institution, the common theme is that many patients, regardless of if they were Black or white, were just not asked,” Hughes-Halbert said.