Lead­ing a Rev­o­lu­tion in Can­cer Care Means Fac­ing Health Eq­ui­ty Chal­lenges

Ex­am­in­ing the Crit­i­cal Gap

The last few decades have been years of amaz­ing progress in how we ap­proach can­cer care: em­pha­siz­ing reg­u­lar screen­ings, ear­ly di­ag­noses and treat­ment with tar­get­ed ther­a­pies that are help­ing many pa­tients live longer and health­i­er than ever be­fore. We in the on­col­o­gy com­mu­ni­ty are proud of the hope we’ve brought to peo­ple fac­ing this dis­ease. How­ev­er, the pan­dem­ic brought to light how health dis­par­i­ties can set us back from achiev­ing our ul­ti­mate goal of elim­i­nat­ing can­cer as a cause of death.

While can­cer in­ci­dence and mor­tal­i­ty are de­clin­ing over­all in the Unit­ed States, mi­nori­ties con­tin­ue to be at an in­creased risk for cer­tain can­cers.^1,2 But we know that dis­par­i­ties in ac­cess and qual­i­ty of care ex­ist across a range of pop­u­la­tions.

The col­or of your skin, where you live, your ed­u­ca­tion lev­el or your so­cial sta­tus can de­ter­mine whether you’re screened reg­u­lar­ly, di­ag­nosed ear­ly, treat­ed with the right med­i­cine for your unique dis­ease, re­ceive high-qual­i­ty care or have the op­por­tu­ni­ty to par­tic­i­pate in ap­pro­pri­ate clin­i­cal tri­als. We have to do bet­ter. First, by un­der­stand­ing the biggest in­equity dri­vers and then work­ing to­geth­er in the on­col­o­gy com­mu­ni­ty to over­come them.

Defin­ing our Role in Ad­vanc­ing Health Eq­ui­ty

We’re led by sci­ence and the promise of cur­ing can­cer in every form. We’re dri­ven to re­lent­less­ly serv­ing our pa­tients. At As­traZeneca, we be­lieve that work­ing to­ward eq­ui­ty in can­cer care re­quires more than a one-size-fits-all so­lu­tion. Here’s how we’re tak­ing ac­tion:

• Aware­ness/Ed­u­ca­tion: Rais­ing aware­ness be­gins with build­ing trust in the health­care sys­tem, help­ing peo­ple un­der­stand their risk fac­tors and the im­por­tance of rou­tine care so that can­cer can be de­tect­ed in the ear­li­er, more treat­able stages. For those di­ag­nosed, we must fo­cus on re­mov­ing the stig­ma of cer­tain types of can­cer while shar­ing treat­ment op­tions and clin­i­cal tri­al da­ta in eas­i­ly un­der­stood lan­guage. All these steps are crit­i­cal to reach­ing un­der­served com­mu­ni­ties, par­tic­u­lar­ly those who have been his­tor­i­cal­ly mis­treat­ed. We al­so have to ex­tend our sup­port to care­givers, em­pow­er­ing them to ad­vo­cate for their loved ones fac­ing can­cer.
• Clin­i­cal Tri­als: The newest treat­ment in­no­va­tions are de­vel­oped in clin­i­cal tri­als. We’re eval­u­at­ing each el­e­ment of tri­al de­sign and ex­e­cu­tion to make par­tic­i­pa­tion eas­i­er for peo­ple who’d most ben­e­fit. How we do this is by re­fin­ing in­clu­sion cri­te­ria in our stud­ies; sim­pli­fy­ing study de­signs and ex­e­cu­tion (e.g., less as­sess­ment, es­tab­lish­ing tri­al sites where pa­tients live, etc.); pro­vid­ing trans­porta­tion sup­port, child­care and fam­i­ly sup­port where need­ed; and com­mu­ni­cat­ing the da­ta in plain lan­guage to pa­tients af­ter the tri­al has con­clud­ed.

To reach the broad­est num­ber of pa­tients, tri­als need to re­flect the di­ver­si­ty of peo­ple who will be treat­ed with those med­i­cines. We’re al­so look­ing at how to en­roll more pa­tients from di­verse back­grounds and part­ner­ing with more in­sti­tu­tions where pa­tient pop­u­la­tions live. By study­ing the re­al-world ev­i­dence from tri­als, we’re able to iden­ti­fy the pain points in a pa­tient’s jour­ney and im­prove the qual­i­ty of care for all pa­tients. These find­ings might even be more rel­e­vant for cer­tain mi­nor­i­ty groups in par­tic­u­lar set­tings, which en­ables us to bet­ter serve them.

• Qual­i­ty of Care and Col­lab­o­ra­tion: We know that there is a clear cor­re­la­tion be­tween op­ti­mal qual­i­ty of care and pa­tient out­comes. From screen­ing those at high risk for de­vel­op­ing can­cer, to bio­mark­er test­ing, to ac­cess­ing the best treat­ments, to ap­pro­pri­ate fol­low-up that will re­duce ad­verse events, to work­ing with a mul­ti­dis­ci­pli­nary team, we’re part­ner­ing with in­ten­tion. Join­ing to­geth­er across the in­dus­try with like­mind­ed or­ga­ni­za­tions helps us to un­der­stand how best to over­come long-stand­ing bar­ri­ers. We’re com­mit­ted to col­lab­o­ra­tion at all lev­els of health­care, in­clud­ing pro­fes­sion­al as­so­ci­a­tions, pa­tient ad­vo­ca­cy groups, pay­ers, physi­cians and hos­pi­tal sys­tems, to best reach pa­tients and re­duce dis­par­i­ties in com­mu­ni­ties na­tion­wide.

Ac­cel­er­at­ing Change To­geth­er

Part­ner­ship is at the heart of our ap­proach to health eq­ui­ty. That’s why in 2021, As­traZeneca cre­at­ed the Health Eq­ui­ty Ad­vi­so­ry Coun­cil (HEAC), bring­ing to­geth­er thought lead­ers from across the health ecosys­tem to pro­vide in­de­pen­dent in­sights and on­go­ing ex­per­tise re­lat­ed to health eq­ui­ty. The fo­cus of HEAC’s long-term roadmap for progress in­cludes im­prov­ing cul­tur­al com­pe­ten­cy of pa­tient and care­giv­er ini­tia­tives, en­sur­ing reach to mi­nor­i­ty pop­u­la­tions and dri­ving in­ter­ven­tions to ad­dress so­cial de­ter­mi­nants of health.

We al­so es­tab­lished Ac­cel­er­at­ing Change To­geth­er (ACT) on Health Eq­ui­ty – a mul­ti-year in­vest­ment in com­mu­ni­ty part­ners to ad­vance health eq­ui­ty pri­or­i­ties na­tion­al­ly and at the com­mu­ni­ty lev­el. This five-year, $25M com­mit­ment aims to im­prove out­comes for pa­tients, with a fo­cus on med­ical­ly un­der­served pop­u­la­tions. As­traZeneca is com­mit­ted to mov­ing the nee­dle on health eq­ui­ty and we know that these in­vest­ments will pay off over time to ben­e­fit the pa­tients and fam­i­lies we serve.

As­traZeneca re­cent­ly joined Pres­i­dent Biden’s Can­cer Moon­shot Goals Fo­rum to strate­gize on how to re­duce the death rate from can­cer by at least 50% over the next 25 years. Our lead­ers have en­gaged with ex­perts from across the pri­vate and pub­lic sec­tors, pa­tient ad­vo­cates and those liv­ing with can­cer to strate­gize how to dou­ble clin­i­cal tri­al en­roll­ment, in­crease eq­ui­ty in tri­als and im­prove ac­cess to screen­ing in rur­al ar­eas.

Look­ing Ahead to the Fu­ture

The rev­o­lu­tion in can­cer care is mov­ing more rapid­ly to­day than ever be­fore. When I think about the num­ber of lives that we’ve been able to touch and will im­pact in the next few years, I’m in awe of what we’ve achieved so far.

Con­fer­ences like the AS­CO An­nu­al Meet­ing re­mind me that for all our ac­com­plish­ments in re­search, every per­son de­serves ac­cess to the life­sav­ing med­i­cines and treat­ments that the in­dus­try is de­vel­op­ing. We still have a lot of work to do but we’re en­er­gized by our progress to date and we’re not slow­ing down. With our col­lec­tive com­mit­ment, we can en­sure that all pa­tients can re­ceive the best pos­si­ble care – no mat­ter their back­ground. To­geth­er, we will elim­i­nate can­cer as a cause of death.

To learn more about our work in health eq­ui­ty and oth­er com­mu­ni­ty-based ini­tia­tives, please vis­it www.as­trazeneca-us.com.

Ref­er­ences:
¹Na­tion­al Can­cer In­sti­tute. Can­cer Dis­par­i­ties. Ac­cessed May 2022.
²Amer­i­can Lung As­so­ci­a­tion. Racial and Eth­nic Dis­par­i­ties. Ac­cessed May 2022.