We are living in an era of explosive medical innovation. In the 1980s medical knowledge doubled every seven years. Today, that doubling rate is every 73 days. Between 2015-2019 over 670,000 cancer-related articles were published globally. Nationally-recognized guidelines for cancer care, which are meant to facilitate clinical decision making for oncologists, have grown increasingly complex: Between 1996-2019, the mean number of decision paths within each NCCN cancer guideline has increased by 370%. This dizzying rate of change can make it difficult for local oncologists to keep up with new treatments and guidelines. And this is leading to growing disparities in access to care based on race, ethnicity, socioeconomic, and demographic factors.
Minority groups, rural communities and medically underserved populations continue to experience barriers to quality cancer treatment, including treatment delays, lack of access to guideline-adherent treatment, undertreatment, refusal or early termination of treatment, and treatment received at low-volume centers. These patients are often treated in community settings because they cannot afford to take time off from work or cannot seek treatment at comprehensive cancer centers due to proximity.
The American Association of Cancer Research (AACR) 2024 Cancer Disparities Progress Report tells an alarming story:
Many cancer care inequities can be attributed to social determinants of health (SDOH), including income, health insurance, and access to healthcare facilities.
Research shows that patients with high household incomes prioritize a cure to their disease when choosing treatment options. However, lower income individuals factor in cost, treatment duration, effect on daily activities, and burden on family and friends.
Access to quality healthcare is one of the most impactful SDOHs. Barriers to this access can be geographical or the lack of insurance, which leads to cost concerns. In a recent study, nearly 27% of uninsured U.S. adults ages 18 to 64 delayed or did not receive needed medical care due to cost, compared to a little over 7% of those with either public or private insurance.
Much of today’s cutting-edge research comes from clinical trials and studies at National Cancer Institute (NCI)-Designated Comprehensive Cancer Centers. But equitable access to these trials remains an issue.
Clinical trials play a crucial role in improving cancer outcomes by providing a platform to test new treatments, identify effective therapies, and advance understanding of cancer. However, disparities in enrollment persist across minority and historically marginalized populations, resulting in a barrier to achieving equitable cancer care. About 7% of diagnosed adults in the U.S. participate in treatment trials. With a majority of clinical trial participants (85%) who are white, middle-aged men, there is a dire need to identify socially vulnerable communities to expand trial opportunities and improve representation in studies.
Additionally, where a person receives cancer treatment plays a crucial role in their outcome. Research shows that outcomes are dramatically better and mortality risk is lowered by 23% when patients are treated at the NCI-Designated Comprehensive Cancer Centers; yet only 20% of cases are actually treated there.
While AccessHope can’t overcome all of the disparities cancer patients face, we are working on reducing geographic barriers. Through a unique partnership with NCI-Designated Comprehensive Cancer Centers across the United States, our unique employee cancer care benefit is democratizing care by providing underserved populations access to the latest research and expertise, including recommendations on applicable clinical trials.
AccessHope provides virtual cancer support and remote second opinions from subspecialists at NCI-Designated Comprehensive Cancer Centers. Through this kind of collaboration, 43% of diagnoses have been updated to more accurately determine the type of cancer. This approach enables subspecialists to collaborate with local oncologists to ensure that patients receive optimal treatment in the most cost-effective and convenient way. Offering employees access to such a leading-edge cancer benefit helps to foster equitable access to the best possible care without having to experience the costs and inconveniences of leaving their local communities and support systems.