Measuring and Addressing Health Equity: An Assessment of Cancer Center Designation Requirements

Details

• Alternative Title:
  Cancer Causes Control
• Personal Author:
  Semprini, Jason T. ; Biddell, Caitlin B. ; Eberth, Jan M. ; Charlton, Mary E. ; Nash, Sarah H. ; Yeager, Katherine A. ; Evans, Donoria ; Madhivanan, Purnima ; Brandt, Heather M. ; Askelson, Natoshia M. ; Seaman, Aaron T. ; Zahnd, Whitney E.
• Description:
  Purpose:
  
  By requiring specific measures, cancer endorsements (e.g., accreditations, designations, certifications) promote high quality cancer care. While ‘quality’ is the defining feature, less is known about how these endorsements consider equity. Given the inequities in access to high-quality cancer care, we assessed the extent to which equity structures, processes, and outcomes were required for cancer center endorsements.
  
  Methods:
  
  We performed a content analysis of medical oncology, radiation oncology, surgical oncology, and research hospital endorsements from the American Society of Clinical Oncology (ASCO), American Society of Radiation Oncology (ASTRO), American College of Surgeons Commission on Cancer (CoC), and the National Cancer Institute (NCI), respectively. We analyzed requirements for equity-focused content and compared how each endorsing body included equity as a requirement along three axes: structures, processes, and outcomes.
  
  Results:
  
  ASCO guidelines centered on processes assessing financial, health literacy and psychosocial barriers to care. ASTRO guidelines related to language needs and processes to address financial barriers. CoC equity-related guidelines focused on processes addressing financial and psychosocial concerns of survivors, and hospital-identified barriers to care. NCI guidelines considered equity related to cancer disparities research, inclusion of diverse groups in outreach and clinical trials, and diversification of investigators. None of the guidelines explicitly required measures of equitable care delivery or outcomes beyond clinical trial enrollment.
  
  Conclusions:
  
  Overall, equity requirements were limited. Leveraging the influence and infrastructure of cancer quality endorsements could enhance progress towards achieving cancer care equity. We recommend that endorsing organizations 1) require cancer centers to implement processes for measuring and tracking health equity outcomes and 2) engage diverse community stakeholders to develop strategies for addressing discrimination.
  
  
• Subjects:
  Delivery Of Health Care Health Equity Humans Medical Oncology Neoplasms United States
• Keywords:
  Cancer Centers Diversity Equity Quality Treatment
• Source:
  Cancer Causes Control. 34(Suppl 1):23-33
• Pubmed ID:
  36939948
• Pubmed Central ID:
  PMC10512189
• Document Type:
  Journal Article
• Funding:
  U48 DP006398/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP006401/DP/NCCDPHP CDC HHSUnited States/ ; 1F31DE032250-01/DE/NIDCR NIH HHSUnited States/ ; U48 DP006399/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP006389/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800012C/CA/NCI NIH HHSUnited States/ ; R01 CA254628/CA/NCI NIH HHSUnited States/ ; U48 DP006396/DP/NCCDPHP CDC HHSUnited States/ ; T32 CA116339/CA/NCI NIH HHSUnited States/ ; T32-CA-116339/CA/NCI NIH HHSUnited States/ ; R01CA254628/CA/NCI NIH HHSUnited States/ ; P30 CA086862/CA/NCI NIH HHSUnited States/ ; U48 DP006399; U48 DP006377; U48 DP006396; U48 DP006413; U48 DP006389; U48 DP006400; U48 DP006401; U48 DP006398/CC/CDC HHSUnited States/ ; F31 DE032250/DE/NIDCR NIH HHSUnited States/ ; U48 DP006377/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP006400/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP006413/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800012I/CA/NCI NIH HHSUnited States/
• Volume:
  34
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:3d470afc5ff210e3596a9575ffe71393dd68c82376ec713492508976e14798c0f2d56dd0e48ea4c5b1729e8022461744270c74bab66e71ebbbeb4f64e888e3f3
• Download URL:
  https://stacks.cdc.gov/view/cdc/133270/cdc_133270_DS1.pdf
• File Type:
  [PDF - 107.16 KB ]