Doctors Drastically Reduce Racial Disparities in the Treatment of Early Lung Cancer – ScienceDaily

"These results are promising for all cancer treatment centers," said Samuel Cykert, MD, professor of medicine at the UNC School of Medicine and co-principal investigator of the trial. "One of the participating institutions, Cone Health, located in Greensboro, North Carolina, currently employs it to permanently implement this intervention in its bad and lung cancer care, and we wish to perform additional tests with all cancer patient populations. "

Cykert and her colleagues have already conducted studies in 2005 and 2009 to understand why racial disparities exist in the treatment of cancer. They found several reasons that contribute to the overall reduction in treatment.

"We found that many clinicians had an implicit bias that made them less willing to take the same risks with patients different from these," said Cykert. "A black and white patient of the same age could require the same surgery, the same comorbidities, the same income and the same insurance, but the white patients were more likely to undergo the operation and receive their cancer."

Cykert says that they also discovered that black cancer patients who did not have a regular source of care could have problems with trust or communication problems with doctors, doctors, and doctors. leading to the total abandonment of treatment. They also found that the denial of their diagnosis played a role in patients seeking treatment.

"Based on this knowledge, we wanted to put in place a system highlighting these failures in care or communication in real time, to help us keep track of patients who would otherwise fall out of the network," he said. Cykert.

The intervention consisted of three parts: a real-time alert system derived from electronic health records, a feedback on treatment completion rates to the attention of patients. Clinical teams and a nurse-navigator to interact with patients throughout the treatment.

The real-time alert system warned the navigating nurses when a patient missed an appointment or went through a treatment step. The navigator then asked the patient to re-engage and bring him back for treatment. Flight nurses were encouraged to become familiar with patients and to build trust in missed appointments, poor physician-patient communication, or any other circumstance that could create a potential barrier to care.

Cykert, who is a member of the UNC Lineberger Cancer Center, said he developed this intervention model with the help of the Greensboro Health Disparities Collaborative, a university-community partnership with community-based participatory research. Their goals were to create elements of real-time transparency, race-based accountability and strengthen patient-centered communication.

The Cykert team recruited patients aged 18 to 85 from two prospective multi-institutional trials using identical interventions. Nearly 240 patients were enrolled in a study sponsored by the American Cancer Society and about 120 patients with lung cancer were enrolled in a study sponsored by the National Cancer Institute. Cykert was the principal investigator in the first trial and co-investigator in the second trial with Geni Eng, DrPH, of the Gillings World School of Public Health of the UNC, and a national expert in participatory community research.

Alongside the Lineberger UNC comprehensive care center and the Cone Health Cancer Center, the Leo Jenkins Cancer Center at East Carolina University, the University School of Medicine of South Carolina and the Hillman Cancer Center of the University of Pittsburgh Medical Center participated in the trial.

The researchers are currently submitting a grant proposal to the National Cancer Institute to implement this intervention to cover the entire population of cancer centers rather than studying patients. alone.