Dr. Alexandre Chan and experts in cancer supportive care led an international survey to evaluate current disparities in cancer supportive care access around the world. The survey was organized and conducted by the Multinational Association of Supportive Care in Cancer (MASCC) Health Disparities Committee and distributed to MASCC members.
The findings, published in Cancer Medicine, demonstrate the prevalence of certain cancer care disparities and showcase the differences in observed disparities in the United States, high-income countries (HIC) outside of the United States, and low- and middle-income countries (LMIC). The survey presented participants with questions regarding their opinions on cancer-related disparities of the highest importance (such as social services access, cancer drug affordability, supportive care drug affordability, availability of supportive care guideline in local context, implementation of supportive care guideline, availability of evidence-based cancer care guideline in local context, timely cancer care, timely supportive care, and technology utilization) and population groups in their countries that are mostly likely to face disparities (such as rural populations, pediatric/adolescent and young adult patients, geriatric patients, LGBTQ+ patients, race/ethnic minorities [including indigenous groups], and economically disadvantaged populations).
“Overall, timely cancer care and timely supportive care were ranked as the highest cancer-related disparities. This reflects the results from high-income countries, the United States, minorities, and non-minorities, where timely cancer care and timely supportive care were ranked as the most important disparities. In contrast, participants from low-income countries reported timely cancer care and both cancer drug affordability and implementation of supportive care guidelines as the most important disparities in their country or region,” said Dr. Chan, who is the corresponding author on the study. The research team included Lawson Eng, Changchuan Jiang, Yu Ke, Mary Tanay, Cristiane Bergerot, Niharika Dixit, Ana Cardeña Gutiérrez, Ana I. Velazquez, Farhad Islami, and Enrique Soto-Perez-de-Celis, as well as Chan Lab undergraduate researcher Mary Dagsi.
“The rankings of cancer care disparities differ notably between participants from HICs, particularly the United States, and LMICs. In HICs, excluding the United States, the economically disadvantaged and rural populations were prioritized. In contrast, US participants placed the highest concern on race/ethnic minorities, followed by economically disadvantaged and rural populations. Meanwhile, participants from LMIC ranked economically disadvantaged groups first, with pediatric/AYA and LGBTQ+ also recognized,” he continued.
The results of this survey will allow researchers and care providers to address the most prevalent issues according to participant responses and develop targeted intervention strategies for improving cancer research and methods of care based on the reported needs in low-, middle-, and high-income countries.
“These findings are important because it highlights the challenges that patients experience based on their country or region. Timely cancer care and supportive care are critical to improving patient outcomes across various populations. These two disparities being prioritized by HICs, the United States, minorities, and non-minorities displays a shared global concern. In contrast, the priorities observed in LMICs reveal specific barriers different from HICs and the United States, such as drug affordability and the implementation of supportive care guidelines. This suggests that interventions must be tailored to the unique needs of LMICs, rather than applying a universal approach,” Dr. Chan explained.
“To effectively address these global issues, we propose utilizing a structured approach to integrate research finding into practice by emphasizing tailored dissemination strategies that account for regional context and barriers.”
