Today at the National Press Club, the American Society of Clinical Oncology (ASCO) announced a new task force aimed at reducing disparities and improving outcomes for patients and survivors of cancer who live in rural communities. The new “Rural Cancer Care Task Force” will identify opportunities to close the rural cancer care gap and implement strategies to improve rural cancer care in the United States.
Patients living in rural areas are often diagnosed with more advanced cancer and have recently been shown to have higher mortality. Persistent issues with access to screening and treatment, as well as higher rates of behavioral risk factors, may be key contributors to this disparity. Transportation and insurance coverage issues exacerbate barriers to obtaining high-quality cancer care.
“We’ve made notable progress in improving outcomes for many people with cancer, but too many individuals, especially in rural communities, are left behind,” said ASCO Chief Executive Officer Clifford A. Hudis, MD, FACP, FASCO. “With this new initiative, ASCO will identify ways to build upon existing efforts while also trying new approaches aimed at improving access to cancer care for patients no matter where they live.”
Last fall, a task force comprised of ASCO Board and committee members was charged with developing a needs assessment and proposed strategy for how ASCO can better address the needs of cancer care patients and providers in rural settings. The group analyzed the factors contributing to rural cancer care disparities, and reviewed efforts (past and present) to improve access to high-quality care in rural areas. Ultimately, the group identified several areas where ASCO could better support rural oncology providers and the patients they serve:
- Provider education and training – Equip all members of the cancer care team (including oncologists, primary care providers, advanced practice providers, and other non-oncology specialists) with specialized training and support so that they are prepared to care for patients throughout their cancer journey from active cancer treatment through survivorship and end of life care
- Workforce – Improve understanding of the unique needs of the rural cancer care workforce, and identify and promote opportunities to expand access for people in rural communities to cancer care services
- Tele-oncology – Address broadband access, reimbursement policies, and other solutions that would allow patients in rural areas remote access to cancer care
- Research – Develop research to better understand the magnitude of differences in outcomes in rural and non-rural settings, and enable patients living in rural areas to access clinical trials more easily
ASCO's new Rural Cancer Care Task Force will focus on identifying actionable approaches to tackle these key areas to improve access to high-quality care. The task force, which will begin its work this summer, will be composed of a multidisciplinary group of clinicians and other experts in the area of rural cancer care.
This new task force builds on the society’s long-standing work to actively address health disparities to ensure that all individuals with cancer have access to high-quality cancer care. The task force will sit within ASCO’s Health Equity Committee, which works to address all types of inequity in cancer care and access. In 2009, ASCO published a statement on disparities in cancer care, which detailed a multi-pronged approach to addressing cancer care disparities.
Since then, ASCO has integrated a focus on cancer equity in the Society’s overall mission and activities. In 2011, ASCO issued a policy statement that examined disparities in cancer care and opportunities to reduce them through the Affordable Care Act, such as focusing efforts on community health centers, improving prevention and wellness care, and improving data collection. In 2014, the society released its principles for Medicaid reform, which continues to guide ASCO’s advocacy efforts to improve low-income Americans’ access to high-quality care, including equitable access to clinical trials. In 2017, ASCO issued a policy statement to offer concrete solutions to reduce disparities in cancer care for sexual and gender minorities and collaborated with Friends of Cancer Research to put forth comprehensive recommendations to broaden eligibility criteria to expand the population of patients who could participate in clinical trials. ASCO expects to publish an update of the 2009 disparities statement later this year.
“I grew up on a ranch in rural Wyoming, so I understand what it means for a patient to be 100 miles from the nearest hospital and the kind of burden that it places on patients, caregivers, providers, and the community as a whole," said ASCO President Monica Bertagnolli, MD, FACS, FASCO. “It’s a sad truth that where a patient lives often dictates their chances of surviving cancer.”
Dr. Hudis announced the new task force during ASCO’s State of Cancer Care in America™ Event: Closing the Rural Cancer Care Gap, which brought together leading physicians, thought leaders, and other rural cancer care experts for a discussion on the challenges facing patients with cancer in rural areas, as well as some of the solutions that are helping to address this gap in cancer care. ASCO is planning to develop a paper summarizing some of the insights from today’s panel discussion, along with new research findings related to cancer care in the rural United States. The paper will be submitted for publication as part of ASCO’s State of Cancer Care in America series in the Journal of Oncology Practice in late 2019 or early 2020.
A recording of Closing the Rural Cancer Care Gap is available at asco.org/state-of-cancer-care.
To learn more about ASCO’s initiatives related to health disparities, please visit asco.org.