This Week's Advocacy News: 'Childhood Cancer Declining, but Stalled for Black and Hispanic Youth: CDC'
Cancer death rates among children and teens dropped in the past two decades, according to new data from the Centers for Disease Control and Prevention (CDC), but that decline has stalled over the past 10 years among Black and Hispanic children. In the first decade, all races saw a similar decline in the cancer death rate. But between 2011 and 2021, the death rate dropped only slightly for Hispanic youth and increased for Black youth. In 2021, the death rate for White youth was 19%–20% lower than for Black and Hispanic youth, the CDC found.
Race, Insurance, and Practice Setting Influence Aggressiveness of End-of-Life Care
White patients with commercial insurance receiving care in a community setting are most likely to receive systemic anticancer therapy at the end of life, researchers reported in study findings published in the Journal of Clinical Oncology.
This Week's Advocacy News: 'How AI Can Make Cancer Treatment More Equitable'
The Cancer Moonshot plan identifies five priority areas, all of which artificial intelligence (AI) has the potential to enhance. Two areas in particular lend themselves to AI: the call to "deliver the latest cancer innovations to patients and communities" and the aim of enhancing "the oncology model to place cancer patients at the center of decision-making."
Race, Age, Chemo, and Other Factors Increase Patients’ Risk for Breast Cancer–Related Lymphedema
Black or Hispanic individuals, those who’ve received neoadjuvant chemotherapy, and older individuals are more likely to experience lymphedema after breast cancer treatment with axillary lymph node dissection and radiation therapy, researchers reported in JAMA Oncology.
Social Determinants Have Clinically Meaningful Effects on Breast Cancer Outcomes
A patient’s race and the neighborhood in which they live can meaningfully lower time to progression and overall survival for triple-negative metastatic breast cancer, oncology nurse researchers reported in the Oncology Nursing Forum.
Health Disparities Have Cancer Implications for Indigenous People. Here’s How to Provide Culturally Competent Care.
Among all racial and ethnic groups, indigenous people (Native American and Alaska Natives) had the largest decline in life expectancy from 2020–2021. They also have the lowest overall life expectancy (65.2 years) than any of their Asian, Black, Hispanic, or White counterparts—in some cases, up to 20 years shorter. Indigenous people have disproportionately high rates of suicide, chronic liver disease, cardiac disorders, diabetes, and infant and maternal mortality.
Experienced Racism Contributes to Poor Cancer Survivorship Outcomes
Cancer survivors from historically marginalized racial and ethnic groups who experience racism are more likely to report physical, mental, sleep, and activity issues during survivorship, researchers reported in study results published in Cancer.
United States and European Union Form Joint Task Force to Tackle Global Health Issues
Joining two powerful entities may be what it takes to overcome cancer and global health threats and improve health architecture around the world. In May 2023, U.S. Secretary of Health and Human Services Xavier Becerra and the European Union Commissioner for Health and Food Safety Stella Kyriakides announced that the countries had formed the EU–U.S. Health Task Force, a new joint effort to address global health.
FDA’s Oncology Center of Excellence Establishes National Black Family Cancer Awareness Week
Cancer affects millions of people worldwide, and certain populations face a disproportionate burden of incidence, mortality, access to care, and representation in clinical trials. Oncology nurses can be a voice for their patients and an advocate for vulnerable individuals.
Health Disparities Take a Toll on the U.S. Economy, NIH-Funded Study Finds
Racial and ethnic health disparities cost the U.S. economy $451 billion in 2018, a 41% increase from the 2014 estimate of $320 billion, according to results from a study funded by the National Institute on Minority Health and Health Disparities, part of the National Institutes of Health. The researchers also reported that the total burden of education-related health disparities for people with less than a college degree reached $978 billion in 2018.
Innovative Oncology Nurses Break Down Communication Barriers for Patients Who Are Deaf or Hard of Hearing
Many patients with cancer confront complex health disparities, but those with disabilities must muddle through more barriers than those without. As nurses, we have a responsibility to help our patients obtain the best possible care and support them during treatments such as a bone marrow transplantation.
Disability Disparities in Cancer Care
More than one billion individuals worldwide have some type of disability, and the population often faces higher rates of cancer, social determinants of health disadvantages, and greater health disparities. They are also more likely to have risk factors associated with a cancer diagnosis and require close care after a diagnosis that accommodates for their disability.
NINR Promotes Nursing Research to Achieve Health Equity
To address and achieve equity in health care, in fall 2022 the National Institute of Nursing Research (NINR) began offering new funding opportunities for research studies aligned with the scientific framework outlined in the institute’s 2022–2026 strategic plan. The grants are available cyclically with three application periods per year.
Achieve Equity in Patient Communication With These Evidence-Based Approaches
Equalizing the quality of patient-provider communication for Black versus White patients is one way to reduce the systemic racial disparities prevalent in cancer care, researchers reported in study findings published in the November 2022 issue of the Oncology Nursing Forum. They identified critical opportunities for oncology nurses to improve interpersonal communication with Black patients. Nurses are key drivers to affecting change and cancer outcomes for all patients, they reported.
Rural Patients Who Miss Radiation Doses Are More Likely to Die From Cancer
Regardless of residence, nearly 25% of patients with cancer overall miss at least 10% of the doses in their radiation treatment plans—but the implications on outcomes are far greater for patients living in rural areas than their urban counterparts, according to new research findings published in the International Journal of Radiation Oncology, Biology, Physics.
Even During Routine Cancer Care, Financial Hardship Significantly Increases Mortality
Patients with cancer experiencing financial hardship during routine care are nearly 1.5 times more likely to die than those who aren’t, researchers reported in study findings published in JCO Oncology Practice.
Oncology Nurse Navigator Roles Are Transforming Cancer Outcomes for Underserved Rural Patients
Underserved, rural, and economically disadvantaged patients with cancer who are under the care of an oncology nurse navigator are better prepared to begin treatment and require fewer services than non-navigated peers, according to study findings published in the Oncology Nursing Forum (ONF). Authors Williams et al. said that their results indicate greater patient satisfaction.
Nontraditional Oncology Nursing Roles
As cancer care evolves, so do new opportunities for nursing roles. Oncology nurses in any role provide essential cancer care, including addressing disparities and social determinants of health and reducing financial toxicity. However, what sets nontraditional nursing roles apart are the populations they care for, how they provide that care, and how they’re overcoming systemic disparities to ensure that all patients with cancer have equal access to high-quality oncology care.
HRSA-Funded Health Centers and NCI-Designated Cancer Centers Partner to Improve Equity in Cancer Screening
The U.S. Department of Health and Human Services, through the Health Resources and Services Administration, awarded more than $5 million in September 2022 to 11 HRSA-funded community health centers to help underserved populations access cancer screenings and early detection services in partnership with National Cancer Institute-designated cancer centers.
Biden-Harris Administration Make Largest Investment Ever in Navigators for 2023 Open Enrollment Period
Making history as the single largest Navigator organization funding award provided to date, the U.S. Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, invested $98.9 million in grant funding to 59 Navigator organizations in August 2022 to help consumers navigate enrollment and make health coverage more accessible.
Put Underserved Populations at the Forefront of the Sexual Health Conversation
Cancer and its treatments can affect a patient’s body in many ways, including sexual function. However, the historical evidence base is focused on cisgender men and their sexual health post-cancer treatment, with sexual health of women and LGBTQIA+ patients largely ignored. I, and many others, are working to change these disparities in research and practice.
Hispanic Patients See Highest Increase Among Uterine Cancer’s Growing Mortality Rate
Racial and ethnic groups are disproportionately affected by the increase in uterine cancer mortality in the United States, researchers explained in study findings published in JAMA Oncology, with Hispanic patients experiencing the highest burden.
HHS Issues Proposed Rule to Fight Discrimination in Health Care
By prohibiting discrimination on the basis of “race, color, national origin, sex, age, and disability,” the U.S. Department of Health and Human Services’ July 2022 proposed rule strengthens Section 1557 of the Affordable Care Act, improving civil rights protections for patients in certain federally funded health programs.
Low Cost-Related Health Literacy May Prevent Survivors From Following Care Plans
Not understanding terms like deductible, copay, premium, coinsurance, and out-of-pocket maximum prevents many Americans from selecting a health insurance plan that meets their financial needs. Fewer than 40% of patients enrolled in high-deductible healthcare plans engage in effective financial behaviors, such as comparing prices or discussing costs with clinicians. High costs are a barrier for many patients and survivors to access high-quality cancer and survivorship care.
CMS Expands Access to High-Quality Care With Physician Payment Rule Proposal
To decrease cost and increase access to care, in July 2022 the Centers for Medicare and Medicaid Services proposed a conversion factor of $33.08 for the 2023 Physician Fee Schedule.
Single HPV Vaccine Dose May Be Enough to Prevent Cancer
In findings that could have global implications to change the face of female cancers, researchers reported that a single dose of the human papillomavirus (HPV) vaccine is highly effective in protecting young women against cervical infection with cancer-causing HPV types. The study results, which were published in NEJM Evidence, build on the body of evidence supporting single-dose HPV vaccines.
Cost Can Prevent Patients From Receiving Follow-Up Care, Study Suggests
Financial considerations are notable barriers for patients with cancer receiving follow-up cancer care, according to study findings from the National Institutes of Health (NIH) All of Us Research Program.
Cancer Mortality Declines Among Black Patients but Remains Disproportionately High
Death rates fell about 2% per year from 1999–2019 for Black patients with cancer, researchers reported in study findings published in JAMA Oncology; however, the population’s cancer mortality remains higher than other racial and ethnic groups for most cancer sites.
Sexual Minority Populations Are Less Likely to Obtain Cervical Cancer Screenings
Propensity to adhere to cervical cancer screening recommendations varies widely by sexual orientation, researchers reported in study findings published in Cancer. They found that those in sexual minority groups are nearly 50% less likely to have ever undergone a Pap test.
Medicaid Expansion Under Affordable Care Act Reduces Health Disparities in Cancer Survival, New Study Suggests
A greater increase in cancer survivorship may be an outcome from Medicaid expansion under the Affordable Care Act (ACA), according to study results published in the Journal of Clinical Oncology in May 2022.
CDC Reports More Than 1.7 Million New Cancer Cases in 2019
More than 1.7 million new invasive cancer cases were reported in the United States in 2019, according to the U.S. Cancer Statistics from the Centers for Disease Control and Prevention (CDC) updated in June 2022.
Senators Cantwell, Grassley Introduce Bipartisan Bill to Battle Unfair Drug Pricing
Patients with cancer and other healthcare consumers would receive reinforcements in the fight against financial toxicity with new legislation that would “empower the Federal Trade Commission (FTC) to increase drug pricing transparency and hold pharmacy benefit managers (PBMs) accountable for unfair and deceptive practices that drive up the costs of prescription drugs.” U.S. Senators Maria Cantwell (D-WA) and Chuck Grassley (R-IA) introduced the proposed bill in May.
Americans Have Stronger Access to Affordable Health Coverage Through New Biden Executive Order
An April 2022 Biden-Harris administration executive order on Continuing to Strengthen Americans’ Access to Affordable, Quality Health Coverage will protect and strengthen the Affordable Care Act (ACA) and Medicaid. The order directed federal agencies and departments to review existing language and correct regulatory wording that might be inconsistent with the goals of offering more affordable access to health care.
Oncology Navigation Standards Help Patients Overcome Disparities and Barriers to Care
Patients with cancer, especially those from underrepresented groups or who are experiencing racism, inequalities, social determinants of health factors, and other barriers to care, need oncology nurse navigation now more than ever before. Developed as a “strategy to improve outcomes in marginalized populations by eliminating barriers to timely diagnosis and treatment of cancer and other chronic diseases,” navigation has made a difference for patients since its introduction in 1990.
U.S. Representative Pallone Questions Vaping Companies on Teen Marketing
As the U.S. Food and Drug Administration (FDA) continues its review of tobacco and e-cigarette products’ marketing applications, legislators and government officials, such as Energy and Commerce Committee Chair Frank Pallone, Jr. (D-NJ), are taking a stand and sharing their concerns on Big Tobacco’s marketing to teenage audiences.
Teleoncology Addresses Health Disparities With High Satisfaction for Patients and Providers, NCI Shares
Virtual appointments and other telehealth care allow patients and families to have ready access to cancer care from the comfort of their own home, Kevin M. Curtis, MD, medical director of the Center for Telehealth at Dartmouth-Hitchcock Health, said in a March 2022 National Cancer Institute (NCI) blog post praising the service. Curtis also highlighted telehealth’s role in addressing health disparities, its high satisfaction rate with both patients and clinicians, and the service’s future in cancer care research.
Racial and Ethnic Groups Report COVID-19–Related Discrimination, NIH Says
People from all major racial and ethnic minority population groups in the United States report experiencing more COVID-19–related discrimination than White adults, including being threatened or harassed based on a perception of having COVID-19, according to results from a new study funded by the National Institutes of Health (NIH).
Diverse Healthcare Equity Requires Providers and Policymakers to Unite for Change
Systemic racism persists throughout today’s society, presenting barriers to basic human rights and services, including quality health care for millions of people. Overcoming those disparities and achieving social justice require advocacy from all—but especially nurses.
Rural Populations’ Fatalistic Perceptions About Cancer May Contribute to Cancer Disparities
Compared to people living in urban areas, on a nationwide U.S. survey, rural populations were more likely to report believing that cancer is unpreventable and always fatal. Researchers reported the survey findings and analysis in Cancer Epidemiology, Biomarkers, and Prevention.
Nursing Diversity Is Critical to Address Health Disparities
Following the death of George Floyd in May 2020, I found myself surrounded by oncology nurses who recognized the need for immediate action to understand and deconstruct racism, and I began collecting resources to offer continuing education about the effects of racism on cancer outcomes and actions nurses can take to support health equity and diversity in the workforce. Under the mentorship of ONS Past President Mary Gullatte, PhD, RN, ANP-BC, AOCN®, FAAN, I was charged by ONS to co-lead, with ONS member Randy Jones, PhD, RN, FAAN, a national team of ONS cancer disparities and health equity researchers to update the ONS Research Agenda.
Prevent Implicit Bias in Patient Care With These Cultural Conversation Starters
Each clinical encounter with a patient brings together three different cultural perspectives: the patient’s, the nurse’s, and health care’s own culture. Patient-centered care acknowledges and responds to the unique needs and preferences of each patient in the context of their culture. As we approach our patients with respect, humility, and curiosity to learn more, we must ask questions to help prevent assumptions, generalizations, and implicit bias from influencing our interactions.
Specialized Risk Calculator May Reduce Disparities for Black Patients With Breast Cancer
A new risk model tailored for Black patients predicts their risk of developing breast cancer as accurately as current models for White patients, researchers reported in the Journal of Clinical Oncology. Because Black patients are more likely to be younger at diagnosis, present with aggressive or advanced cancer, and die from the disease than other racial and ethnic groups, using the new model to personalize prevention and screening recommendations may reduce those disparities.
White House Initiative Addresses Disparities for Asian Americans, Native Hawaiians, and Pacific Islanders
Advancing equity, justice, and opportunity for Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) communities in the United States requires an ambitious, whole-of-government agenda, the U.S. Department of Health and Human Services (HHS) announced in December 2021. To drive that agenda, the agency launched the Biden-Harris administration’s White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders (WHIAANHPI).
NCI Distinguished Scholar Urges Tackling Disparities Directly
America must make a drastic change in its approach to addressing health disparities for it to ensure adequate healthcare delivery, according to the National Cancer Institute’s Continuing Umbrella of Research Experiences Distinguished Scholars October 2021 speaker Robert Winn, MD.
U.S. Invests in Historic Funding to Drive Equity in Health Care
Unprecedented new funding will expand and diversify the country’s healthcare workforce, address workforce shortages, and support more than 22,700 healthcare providers committed to working in underserved communities, according to a statement from the White House. Vice President Kamala Harris announced the $1.5 billion investment into the National Health Service Corps, Nurse Corps, and Substance Use Disorder Treatment and Recovery programs in November 2021.
New HHS Initiative Will Reduce Maternal and Infant Health Disparities
To reduce the disparities affecting maternity health outcomes, the U.S. Department of Health and Human Services (HHS) Office on Women’s Health (OWH) launched the Maternal Morbidity and Mortality Data and Analysis Initiative, an $8 million contract with Premier, Inc., the agency announced in December 2021. The initiative is rallying a network of hospitals to deploy evidence-based best practices in maternity care.
Fructose Fuels Colorectal Cancer Growth, Study Shows
Excess consumption of fructose in additives like table sugar or high-fructose corn syrup (HFCS) not only contributes to obesity, but it may increase colorectal cancer (CRC) cell survival, leading to larger tumors and increased symptom burden in patients at higher risk, researchers showed in study results published in Nature. However, blocking the body’s uptake of the sweetener may be a key to controlling the disease.