Cancer Equity

Health System and Contextual Factors Associated with Racial Equity in Lung Cancer Care

This explanatory sequential mixed methods study seeks to mitigate racial disparities in non-small cell lung cancer diagnosis, treatment, and outcomes, by identifying modifiable structural and health system/intermediary factors and strategies that influence equity in lung cancer care. We will combine retrospective, population-based studies of racial disparities in lung cancer care with a positive deviance analysis. Through qualitative interviews with key stakeholders in regions with high versus low racial disparities, we will reveal strategies and structures that influence equity in lung cancer care and outcomes. Our hypothesis is that the magnitude of racial disparities varies substantially across counties, and this variation does not arise by accident – there are specific contextual factors, such as structural racism, segregation, and health system factors, that exacerbate disparities.

Funding source: NIH (NIMHD)

Principal Investigator: Cary Gross

Comparative modeling of multiple myeloma across control continuum: prevention, treatment, and disparity reduction

The project, one of the Cancer Intervention and Surveillance Modeling Network (CISNET) Incubator Programs, aims to develop a natural history model for multiple myeloma progression in the United States. The overarching goals will evaluate the impact of novel interventions for multiple myeloma prevention and control, as well as assess whether, under what conditions, and in which ways the goal of eliminating racial disparities can be achieved through the proposed novel intervention strategies and treatment regimens.

Funding source: National Institutes of Health (National Cancer Institute)

Multiple Principal Investigator: Shi-Yi Wang (with Su-Hsin Chang & Graham Colditz)

Community-Rx Cancer: An IT-Enhanced Patient Navigation Program to Address Social Determinants of Health in Advanced Ovarian Cancer

Patients with cancer often have serious unmet health-related basic and self-care needs (HRSNs) that are not systematically assessed in routine cancer care. These potentially modifiable factors can exacerbate socioeconomic disparities and pose challenges to cancer care and recovery. This pilot study seeks to design, implement, and evaluate the effectiveness of a new tool called CommunityRx-Cancer (CRx-Can). CRx-Can will leverage novel technology that can: (1) assess for unmet HRSNs and financial toxicity using validated instruments at two distinct time points, and (2) navigate patients to care navigators and community resources based on their unique needs. Funding Patients with cancer often have serious unmet health-related basic and self-care needs (HRSNs) that are not systematically assessed in routine cancer care. These potentially modifiable factors can exacerbate socioeconomic disparities and pose challenges to cancer care and recovery. This pilot study seeks to design, implement, and evaluate the effectiveness of a new tool called CommunityRx-Cancer (CRx-Can). CRx-Can will leverage novel technology that can: (1) assess for unmet HRSNs and financial toxicity using validated instruments at two distinct time points, and (2) navigate patients to care navigators and community resources based on their unique needs.

Funding source: National Comprehensive Cancer Network & AstraZeneca

Principal Investigator: Cary Gross

Disparities in the Use of Oral Anticancer Agents in Kidney Cancer

We have long known that real-world black-white racial disparities have existed in the treatment and outcomes of patients with renal cell carcinoma (RCC). However, it is unclear how these disparities will change with the recent introduction and widespread adoption of oral anticancer agents (OAAs). As with any advance in medical technology, the introduction of these agents has the potential to significantly improve patient outcomes, but also has the potential to exacerbate current disparities if these advances in OAAs are not equally available or do not provide the same benefit to all patients. The proposed study addresses this critical gap in our knowledge by investigating a mix of nationally representative, yet diverse populations of patients with kidney cancer in the United States to better understand the current and future utilization, outcomes, and costs associated with emerging OAAs in patients with kidney cancer.

Funding source: NIH (NCI)

Principal Investigator: Michaela Dinan