The Oncology Nursing Society (ONS) launched its inaugural ONS Hackathon™ on November 9, 2020, a competition designed to identify innovative ways to address challenging issues in the delivery of quality cancer care. Meghan O. Coleman, DNP, CRNP, and Alison McDaniel, BSN, RN, OCN^®’s winning project, Evidence-Based Quality Understanding in Pathology, provided ways to solve the problem of unequal access to biomarker and other genetic and genomic testing.

Telehealth resources have been present in the United States for several decades. Traditionally, clinicians used telehealth to help rural populations with limited access to care. However, telehealth innovations expand beyond home care coordination. We can use technology to reach even the most remote and vulnerable patients.  

Patients throughout the United States still face persistent inequities across the healthcare continuum because of social determinants of health and inequity in research, Shannon N. Zenk, PhD, MPH, RN, FAAN, director of the National Institute of Nursing Research (NINR) recognized.

Does lack of inclusion in areas that are important to us affect how we see ourselves overall? Can someone amplify their voice without being represented in an authority position? Should leadership reflect the population that it’s leading? More and more medical organizations are publishing formal and informal position statements on diversity and inclusion, which is a great start, but the next logical step is bringing those beliefs and concepts to our institutions and communities. Here are some of the issues and the ways that any nurse can take action.

Nursing’s role in health equity, public health emergencies, and COVID-19 is a critical issue for updates to its Future of Nursing 2020–2030 report study, the National Academy of Medicine (NAM) said during a webinar on August 20, 2020, that sought public input on nurses’ roles in responding to the COVID-19 coronavirus pandemic.

Rural Americans are more likely to have a fatal cancer diagnosis and face additional concerns like fewer hospitals and physicians in a “one-size-fits-all” healthcare system. To address the disparities, the Federal Communications Commission (FCC) partnered with the U.S. Department of Agriculture (USDA) to form the Rural Telehealth Initiative.

A hallmark principle of social work is meeting clients where they’re at. This means taking time to understand where they come from, what might be influencing how they are navigating the healthcare system, and how their cancer diagnosis personally affects them.

Thanks to expanded Medicaid coverage from the Affordable Care Act (ACA), women diagnosed with breast cancer—and in particular, African American women who are more likely to experience breast cancer disparities—are getting their cancers found at earlier stages, according to researchers. The study findings were reported in JAMA Surgery.

Research influences care along every inch of the cancer continuum, from prevention to survivorship, enabling healthcare professionals and patients to share decisions that result in the most current and tailored care strategies. It’s a powerful tool that sets the groundwork for providing optimal health outcomes. However, we must work to eliminate unequal representation.

Every patient deserves equal access to health care. Yet 68% of patients have at least one social determinant of health that serves as a barrier to care.

Black women with breast cancer typically have a worse prognosis than white women, and the results of a new study suggest that insulin resistance may be a factor in the disparity. Findings from the study were reported in Breast Cancer Research.

More than 96% of participants in prostate cancer clinical trials are non-Hispanic white men even though non-Hispanic black men represent 22% of prostate cancer diagnoses, researchers reported in Cancer Epidemiology, Biomarkers, and Prevention. Even more critical, enrollment rates of black or African American men have been declining since 1995.

More research funding is needed to learn about and address health disparities in African Americans in the United States, Tara Schwetz, PhD, National Institute of Nursing Research (NINR) acting director, said in an open letter to the research community. In the bold announcement, NINR recognized the unequal treatment of minorities and the need for enhanced dedication to promote equality in nursing research.

A multitude of factors influenced by institutional inequality, such as underlying health conditions and employment opportunities, are to blame for the COVID-19 coronavirus’s disproportional effects on African Americans, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said. His remarks were part of a June 23, 2020, testimony before the House Energy and Commerce Committee.

Recognized by the National Academies of Medicine as a population vulnerable to health disparities, people who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) experience specific health disparities, including limited access to health care, increased risk for certain disease types, and an inherent bias in the health system.

Many factors can affect the way patients access their care. But one thing is certain: if patients don’t get the care they need, their chances for success decline. To address barriers to cancer care, the American College of Surgeons’ Commission on Cancer (CoC) outlined specific, measurable actions that institutions must take.

On April 21, 2020, a handful of nurses protested outside the White House to urge the president to respond to the critical shortage of personal protective equipment (PPE)—and other nurses around the country have been speaking out as well.  

Clinical trials are a vital part of moving cancer care into the future. Enrollment and participation provide patients with cutting-edge treatments and build the knowledge base for clinicians to offer the best possible care available. Patients who enroll in clinical trials receive a high quality of care, increased surveillance, and a greater adherence to treatment protocols because of the nature of scientific study. However, Latino and African American participation in clinical trials is low compared to their representation in the U.S. population.  

As part of a larger understanding of the social determinants of health, geography—whether it’s rural or metropolitan, urban or suburban—plays a huge part in how patients understand, receive, and access care. Regardless of zip code, community, or travel distance, patients have a right to receive the best possible care for their cancer diagnosis. As staunch patient advocates, oncology nurses are primed to help patients navigate geographic disparities and overcome challenges they face in treatment. 

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in Latina women. Compared to all patients with breast cancer, Latinas are the second most common ethnic group to carry BRCA1 deleterious mutations, after Ashkenazi Jewish women. However, Latinas are less likely to receive genetic counseling education, referrals, and testing services and have the least awareness of genetic testing compared to non-Hispanic whites and other minority populations. Research indicates that despite their low awareness, Latinas have high interest in participating in genetic counseling and testing. 

Typically, African American men have worse outcomes from prostate cancer than their white counterparts. But according to the results of a new study in patients in the U.S. Department of Veterans Affairs (VA) health system where all patients have equal access to care, no disparities exist between the two groups—in fact, the African American men in the VA system had better outcomes than non-Hispanic whites. The findings were reported in Cancer.  

Cancer is a global health problem. According to the American Cancer Society, cancer incidence is expected to continue to grow to nearly 27 million new cases around the world by 2040. In 134 of 183 countries, cancer is the first or second leading cause of premature death for people aged 30–69 years, and it ranks third or fourth in an additional 45 countries. Although cancer is a major health issue across the world, outcomes differ depending on a patient’s country of origin.  

Uninsured women or women on Medicaid are at a greater risk to develop advanced stage III breast cancer compared to women with health insurance, according to the results of a National Institutes of Health (NIH)-funded study reported in JAMA Oncology. Naomi Ko, MD, and Gregory Calip, PhD, noted that up to 47% of racial and ethnic disparities in advanced stage breast cancer could be mitigated by health insurance coverage.

Modest differences may exist among women with diabetes compared to healthy controls when it comes to adhering to screening recommendations for breast, cervical, and colorectal cancers, according to results of a study published in Diabetologia.

The pre-existing condition coverage component of the Affordable Care Act is a bipartisan plank that connects every policy conversation about health care. Public opinion overwhelmingly supports maintaining clauses to protect coverage for those with pre-existing conditions—like cancer—through treatment and survivorship, particularly as people change jobs and insurance companies.

Men have higher death rates than women across all stages of breast cancer, study findings reported in JAMA Oncology show. In the study, five-year overall survival after a breast cancer diagnosis was 77.6% for men and 86.4% for women.

Issues pertaining to geography, socioeconomic status, or racial or ethnic background can prohibit patients from accessing the treatment and care they need to successfully navigate their cancer diagnosis. Connecting patients to healthcare professionals and tailored interventions that educate, motivate, and reduce barriers can be a tremendous boon for their care and ultimately their outcomes.

Although death rates from breast cancer have been falling, the trend has not been equal among all women. Looking at breast cancer survival on a population level can tell us how effective our public health and healthcare systems are at early diagnosis, delivery of evidence-based treatment, and management of follow-up care.

Found along the expansive Appalachian mountain range in the Eastern United States, Appalachia is legally recognized as an economically disadvantaged area that’s home to a unique population of patients requiring special considerations.

Global radiation oncology research has seen an increased commitment to addressing disparities in the world and at home. The more radiation oncology proves and improves itself as a therapeutic modality, the more we are faced with the reality that the odds for survival are related to geography, poverty, education, and race.

Traditionally defined as patients aged 65 and older, older adults make up the majority of patients with cancer. Ambulatory care clinics with a specialized focus on older patients with cancer can provide age-specific care and an interprofessional team of providers well versed in cancer, aging, and geriatric assessment. Through geriatric oncology ambulatory care clinics, providers can work together to identify and coordinate plans to individualize treatment and supportive care for older patients.  

The Baby Boomer generation—born between the years 1946 and 1964—currently accounts for more than 76 million Americans, all of whom will be older than 65 in the next decade. With an aging population comes health complications and growing comorbidities. Cancer is often referred to as a disease of the aging, and healthcare providers will need to be equipped to treat the impending wave of older adults with cancer. Oncology nurses are at the frontlines of that care and play a key role in the successful treatment of older patients with cancer using evidence-based interventions and age-specific care. 
 

U.S. incidence rates for aggressive uterine cancer subtypes are quickly rising for women aged 30-70, especially among non-Hispanic black women, according to results of a study published in the Journal of Clinical Oncology.

Cancer knows no race, color, nationality, or ethnicity. But although any person may one day develop cancer, incidence and mortality rates for some cancers are disproportionately higher in certain racial, ethnic, geographic, or socioeconomic groups. Here are just a few of the many identified cancer disparities, according to the National Cancer Institute.

In an increasingly rare show of bipartisan common ground, U.S. Senators Todd Young (R-IN) and Doug Jones (D-AL) introduced the Nursing Where It’s Needed (Nursing WIN) Act in April 2019. The bill would assist nurses in underserved areas of the country—particularly rural communities—that are facing nursing staff shortages.

Through a combination of expert clinical knowledge, relationship-building skills, and routine selection as the most trusted profession in the United States, nurses are one of the most impactful healthcare professionals when it comes to addressing patient issues. Challenges—like financial toxicity and limited access to care—are central to nursing advocacy efforts, and oncology nurses know firsthand the negative impacts they have on patients with cancer.

The National Institutes of Health’s (NIH’s) mission is to enhance health and reduce illness throughout the country. Cancer, as the second leading cause of death in the United States, tops the list of diseases on which NIH is focused. Understanding the impact of health disparities, NIH has effectively widened its reach to touch more underserved communities with new prevention efforts.

Underserved communities largely have low rates of cancer genetic testing. Although the reasons vary, they can include lack of referrals, no or underinsurance, prohibitive cost, lack of trust, lack of knowledge, discrimination issues, or competing health needs.

The Health Resources and Services Administration (HRSA) announced $293 million in new funding through programs at the National Health Service Corps (NHSC) and Nurse Corps for the healthcare community to expand the clinician workforce. Strengthening care and support can help address gaps in care and limit growing socioeconomic disparities.

Congress has settled in after the shutdown, and new members have taken their place on committees to begin the real work in Washington, DC. This week, the House and Senate convened similar panels to discuss the bipartisan goal to lower soaring drug costs for all Americans. Patients and families provided emotional testimony about lost loved ones because of pricey prescription medications that were out of reach.

Race and economics are still driving cancer treatment and survivorship, ONS member Janice Phillips, RN, PHD, FAAN, explained in her article, “Unfair Diagnosis: Socioeconomic Gap Drives Cancer Outcomes,” published in January 2019 in Scientific American.

A new study demonstrated that pediatric cancer rates vary by U.S. state and geographic region, with the highest rates in the Northeast, specifically New Hampshire; Washington, DC; and New Jersey. The study findings were published in Morbidity and Mortality Weekly Report.

To better understand environmental and genetic impacts associated with prostate cancer in African American men, the National Institutes of Health (NIH) began a new study, Research on Prostate Cancer in Men of African Ancestry: Defining the Roles of Genetics, Tumor Markers, and Social Stress (RESPOND). The research program has received more than $26 million in funding and seeks to understand why African American men have disproportionally higher rates of aggressive prostate cancer than any other racial or ethnic population.

Cancers are never confined by borders. For most disease types, the ones seen in clinics and institutions throughout the United States are the same found in other first-, second-, and third-world countries. The realities facing cancer, treatments, and patient outcomes are often challenging to address no matter where you live, and it’s one of the many common threads that tie oncology professionals together the world over.