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A pilot project from the National Comprehensive Cancer Network® (NCCN®), based on work from the Elevating Cancer Equity initiative—a joint program from NCCN, the American Cancer Society Cancer Action Network (ACS CAN) and the National Minority Quality Forum (NMQF) and steered by Massey Cancer Center leaders—seeks to bring cancer care providers to the top of the class. The Elevating Cancer Equity working group’s Health Equity Report Card (HERC) offers actionable recommendations to reduce racial disparities in access to cancer care.

The impact of structural and interpersonal racism is one of the major causes of disparities in cancer outcomes in the United States. According to the American Cancer Society, Black people have the highest death rates and shortest survival rates of any racial/ethnic group in the U.S. for most cancers: Black women have 8% lower cancer incidence but 12% higher mortality than white women. Black men have 6% higher cancer incidence than white men and 19% higher cancer mortality.

The pilot project follow-up to the Elevating Cancer Equity initiative was announced on World Cancer Day to draw attention to inequities in cancer care and close the care gap. The initiative’s working group is co-chaired by Robert A. Winn, M.D., director and Lipman chair in oncology at Massey Cancer Center. The HERC was developed by the working group and contains 17 practice-level recommendations to improve equitable cancer care.

In early 2021, the group developed the HERC to recommend practice changes which, if implemented, would help providers and health care organizations identify and avoid discriminatory behaviors and bias in care delivery, address social determinants of health and overcome systemic barriers to optimal care.

“Your ZIP code and the neighborhood where you live impact many aspects of health, including cancer onset and outcome; beyond that, we know there is also implicit and explicit bias in care delivery,” said Winn. “These factors leave minority patients with an undue burden of cancer and impact incidence and survival rates. We’re excited about the potential of the Health Equity Report Card to help ensure the same standards of guideline-driven care are provided to every cancer patient, no matter their background or geographic location.”

The 17 actionable practice changes from the HERC have been refined into an implementation plan including concrete metrics, sources of evidence, and a scoring methodology, all of which were vetted by oncology administrators and healthcare providers. It is now being piloted at five leading academic cancer centers to assess the feasibility of implementing the HERC as a tool that can both meaningfully and feasibly measure and report on equitable care practices. The Merck Foundation through its Alliance for Equity in Cancer Care is providing grant funding to partially support implementation of the HERC.

“We expect quality and safety reports from our health care institutions. Health equity reports should become the norm as well,” said Winn. “When we commit ourselves to that level of accountability we can better earn and deserve the trust of our communities.”

Written by: Annie Harris