scholarly journals Development of an Actionable Framework to Address Cancer Care Disparities in Medically Underserved Populations in the United States: Expert Roundtable Recommendations

2021 ◽  
pp. OP.20.00630
Author(s):  
Karen M. Winkfield ◽  
Jeanne M. Regnante ◽  
Ellen Miller-Sonet ◽  
Evelyn T. González ◽  
Karen M. Freund ◽  
...  
Keyword(s):  
Cancer Care ◽  
Underserved Populations ◽  
The United States ◽  
Medically Underserved ◽  
Institute Of Medicine ◽  
Environmental Scan ◽  
Target Populations ◽  
Care Access ◽  
Patient Organizations ◽  
Medically Underserved Populations

PURPOSE: Cancer disparities persist among medically underserved populations despite widespread efforts to address them. We describe the development of a framework for addressing cancer care disparities across the cancer care continuum (CCC), guided by the CCC domains established by the Institute of Medicine/National Academies of Sciences, Engineering, and Medicine (IOM/NAS). MATERIALS AND METHODS: An environmental scan was conducted to identify strategies and associated experts who are providing or have successfully provided community- and/or patient-centric IOM/NAS-defined domain standards to our target populations. A multistakeholder expert roundtable working group was convened for framework development. A premeeting survey informed agenda development, documented expert practices for target populations, and identified priority areas for meeting focus. RESULTS: The environmental scan identified 84 unique experts across 8 stakeholder groups and 44 patient organizations; 50 were invited to the roundtable and 33 participated. They broadly represented disease sites, geography, and experience with target populations and all CCC domains. The premeeting survey (16 responses) identified coordination of care or patient navigation (66.7%), community engagement (60.0%), and healthcare system changes (53.3%) as priority focus areas. The experts identified access and treatment barriers or gaps within and between CCC domains, specified key notable practices to address these, and developed an actionable framework and recommendations for each priority focus area. CONCLUSION: The framework and recommendations are intended to guide researchers, healthcare leaders, advocates, community- and patient-focused service organizations, and policy leaders to address and promote health equity in cancer care access and treatment outcomes.

scholarly journals Increasing uptake of colon cancer screening in a medically underserved population with the addition of blood-based testing

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie Ioannou ◽  
Kyle Sutherland ◽  
Daniel A. Sussman ◽  
Amar R. Deshpande
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Colon Cancer ◽  
Cancer Screening ◽  
Underserved Populations ◽  
The United States ◽  
Colon Cancer Screening ◽  
Medically Underserved ◽  
Medically Underserved Populations

Abstract Background Adherence to colorectal cancer screening in the United States is suboptimal, particularly in medically underserved populations due to significant barriers to care. Unique accessible, low-cost, and non-invasive screening tests for this population could greatly benefit current rates. In this article, we assess patient preference and the impact of offering a blood-based test on screening rates in a cost-free health fair setting from April 2017 to April 2019. Methods Participants who met colorectal cancer screening eligibility criteria set forth by the United States Preventive Services Task Force were recommended to attend the colon cancer screening station. Those participants who elected to attend were offered various, accepted screening methods, and if they declined, were offered alternative blood-based testing. Screening rates, test outcomes, and the rate of follow up completion of colonoscopy were measured and compared with historic screening outcomes. Results Of 1401 participants who were recommended to attend, 640 (45.7%) participants were evaluated at the colon cancer screening station, of whom 460 were eligible for testing. Amongst these, none selected colonoscopy, 30 (6.5%) selected fecal immunochemical testing, and 430 (93.5%) selected blood-based testing. Only 2 participants returned the fecal immunochemical tests. In the blood test cohort, 88 were positive and 20 received a follow up colonoscopy. Conclusions Based on this assessment, blood-based testing is an effective method to increase screening rates in medically underserved populations, though efforts to further improve access to follow up colonoscopy are necessary.

scholarly journals Telemedicine Services During COVID‐19: Considerations for Medically Underserved Populations

2020 ◽  
Vol 37 (1) ◽  
pp. 231-234 ◽  
Author(s):  
Tasha Woodall ◽  
Melinda Ramage ◽  
John T. LaBruyere ◽  
William McLean ◽  
Casey R. Tak
Keyword(s):  
Underserved Populations ◽  
Medically Underserved ◽  
Medically Underserved Populations

Proposed Agenda for the Measurement of Quality-of-Care Outcomes in Oncology Practice

1999 ◽  
Vol 17 (8) ◽  
pp. 2614-2614 ◽  
Author(s):  
Jeanne S. Mandelblatt ◽  
Patricia A. Ganz ◽  
Katherine L. Kahn
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
Outcome Measures ◽  
Cancer Care ◽  
The United States ◽  
Leadership Role ◽  
Institute Of Medicine ◽  
Oncology Practice ◽  
The Impact

ABSTRACT: Cancer is an important disease, and health care services have the potential to improve the quality and quantity of life for cancer patients. The delivery of these services also has recently been well codified. Given this framework, cancer care presents a unique opportunity for clinicians to develop and test outcome measures across diverse practice settings. Recently, the Institute of Medicine released a report reviewing the quality of cancer care in the United States and called for further development and monitoring of quality indicators. Thus, as we move into the 21st century, professional and regulatory agencies will be seeking to expand process measures and develop and validate outcomes-oriented measures for cancer and other diseases. For such measures to be clinically relevant and feasible, it is key that the oncology community take an active leadership role in this process. To set the stage for such activities, this article first reviews broad methodologic concerns involved in selecting measures of the quality of care, using breast cancer to exemplify key issues. We then use the case of breast cancer to review the different phases of cancer care and provide examples of phase-specific measures that, after careful operationalization, testing, and validation, could be used as the basis of an agenda for measuring the quality of breast cancer care in oncology practice. The diffusion of process and outcome measures into practice; the practicality, reliability, and validity of these measures; and the impact that these indicators have on practice patterns and the health of populations will be key to evaluating the success of such quality-of-care paradigms. Ultimately, improved quality of care should translate into morbidity and mortality reductions.

scholarly journals Delivering High-Quality and Affordable Care Throughout the Cancer Care Continuum

2013 ◽  
Vol 31 (32) ◽  
pp. 4151-4157 ◽  
Author(s):  
Ya-Chen Tina Shih ◽  
Patricia A. Ganz ◽  
Denise Aberle ◽  
Amy Abernethy ◽  
Justin Bekelman ◽  
...  
Keyword(s):  
Cancer Care ◽  
Primary Care Physicians ◽  
New Technologies ◽  
Financial Burden ◽  
The United States ◽  
Institute Of Medicine ◽  
High Quality ◽  
Care Continuum ◽  
Quality Cancer Care ◽  
Cancer Care Continuum

The national cost of cancer care is projected to reach $173 billion by 2020, increasing from $125 billion in 2010. This steep upward cost trajectory has placed enormous an financial burden on patients, their families, and society as a whole and raised major concern about the ability of the health care system to provide and sustain high-quality cancer care. To better understand the cost drivers of cancer care and explore approaches that will mitigate the problem, the National Cancer Policy Forum of the Institute of Medicine held a workshop entitled “Delivering Affordable Cancer Care in the 21st Century” in October 2012. Workshop participants included bioethicists, health economists, primary care physicians, and medical, surgical, and radiation oncologists, from both academic and community settings. All speakers expressed a sense of urgency about the affordability of cancer care resulting from the future demographic trend as well as the high cost of emerging cancer therapies and rapid diffusion of new technologies in the absence to evidence indicating improved outcomes for patients. This article is our summary of presentations at the workshop that highlighted the overuse and underuse of screening, treatments, and technologies throughout the cancer care continuum in oncology practice in the United States.

scholarly journals Increasing uptake of colon cancer screening in a medically underserved population with the addition of blood-based testing

2020 ◽  
Author(s):  
Stephanie Ioannou ◽  
Kyle Sutherland ◽  
Daniel A. Sussman ◽  
Amar R. Deshpande
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Underserved Populations ◽  
Colon Cancer Screening ◽  
Medically Underserved ◽  
Screening Methods ◽  
Medically Underserved Populations ◽  
Medically Underserved Population ◽  
The Impact

Abstract Adherence to colorectal cancer screening is suboptimal, particularly in medically underserved populations. We report here on our assessment of the impact of offering a blood-based screening test on screening rates in a health fair setting. Patients attending student-run health fairs who met colon cancer screening guideline eligibility criteria received a recommendation to attend that screening station. Patients were offered recommended accepted screening methods, and if they declined they were offered blood-based testing. Screening rates, test outcomes, and the rate of follow up completion of colonoscopy were measured and compared with historic screening outcomes. Of 1401 screening eligible patients, 640 (45.7%) attended the colon cancer screening station, of whom 460 were eligible for assessment. Amongst these, none selected colonoscopy, 30 (6.5%) selected FIT, and 430 (93.5%) selected blood-based testing. Only 2 patients returned the FIT. For the blood test, 88 were positive, and 20 of these received a follow up colonoscopy. Based on this assessment, blood-based testing is an effective method to increase screening rates in medically underserved populations, though efforts to further improve access to follow up colonoscopy are necessary.

scholarly journals 948: Addressing medically-underserved populations through a maternal-fetal transport system

2018 ◽  
Vol 218 (1) ◽  
pp. S562
Author(s):  
Joshua I. Rosenbloom ◽  
D. Michael Nelson ◽  
Scott Saunders ◽  
F. Sessions Cole ◽  
George A. Macones ◽  
...  
Keyword(s):  
Transport System ◽  
Underserved Populations ◽  
Medically Underserved ◽  
Medically Underserved Populations
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