In August 2020, the American Society of Clinical Oncology issued a policy statement with new recommendations to reduce cancer disparities and drive equitable access to care for all people with cancer.1
“Over the past decade, despite novel diagnostics and therapeutics, together with changes in the cancer care delivery system such as passage of the Affordable Care Act, cancer disparities persist,” the statement said. “Our understanding of the populations experiencing disparate outcomes has likewise expanded to include the intersections of race/ethnicity, geography, sexual orientation and gender identity, sociodemographic factors, and others.”
The statement included a series of recommendations that fell into 4 main areas, 1 of which was addressing structural barriers to equitable care.
A study published recently in the Journal of General Internal Medicine attempted to do just that by studying how organizational factors related to communication and coordination of care helped or hindered timely follow-up for abnormal mammograms.2 The study found that certain improvements in communication may help improve how likely women are to follow-up on abnormal mammogram results.
“Based in the team’s collective experience conducting breast cancer and health services research and providing patient care, we knew that results communication was not standardized across health systems — but we didn’t know how this lack of standardization and range of approaches impacted the ability of women of diverse ethnic, cultural, and language backgrounds to receive their abnormal mammogram results, understand the findings, understand follow up instructions, and engage in follow up care,” explained study author Nancy J. Burke, PhD, professor at University of California, Merced. “The qualitative approach we employed enabled us to create an evidence base of the organizational arrangements that impact timely follow-up.”
Dr Burke and colleagues used 61 in-person interviews to gather this information from women across 4 racial/ethnic groups: African American, Chinese, Latina, and White. All participants had an abnormal mammogram result that required breast biopsy, as documented in the San Francisco Mammography Registry the previous year. Patients had received care at either an academic center, a community center, or a safety-net facility.
The in-depth interviews lasted 40 to 60 minutes. During the interview, participants were asked to reflect on their care experience, including how they were notified on their results, experiences scheduling appointments and subsequent procedures, coordination of follow-up care, and whether they had recommendations for improvement.