Few studies offer strategies for reducing pediatric cancer survivorship disparities
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Although studies have identified racial disparities in care among pediatric cancer survivors, few have focused on interventions to address this issue, according to a technical brief presented at the Cancer Care Survivorship Research Forum.
“We were surprised to find only eight studies in progress evaluating disparities and barriers,” Erin M. Mobley, PhD, MPH, assistant professor in the department of surgery at University of Florida College of Medicine, said during the presentation. “Interestingly, we found that only one of those studies was truly designed in an effort to address disparities in survivorship care.”
The technical brief was conducted by the Agency for Healthcare Research and Quality (AHRQ) and commissioned by the NCI as part of a research agenda associated with the Childhood Cancer Survivorship, Treatment, Access and Research (STAR) Act.
“The STAR Act was passed in June of 2018, and the intention was to advance pediatric and AYA cancer research,” session moderator Emily S. Tonorezos, MD, director of the Office of Cancer Survivorship at the NCI, said during the presentation. “That eventually led the NCI to request AHRQ to produce this technical brief.”
The researchers reviewed databases, registries and published reviews to identify studies related to childhood cancer survivors, defined as individuals diagnosed with any cancer before age 21 years. Key informants offered content expertise about published and ongoing research, and recommended strategies for filling identified gaps.
Researchers identified 110 studies that met inclusion criteria, with 26 studies evaluating disparities in survivorship care among childhood cancer survivors. Informants identified insufficient provider knowledge, lack of accessible services in the health care system and inadequate payer networks as major barriers to care. Forty-seven studies evaluated a large range of barriers to survivorship care, and 16 organizations outlined strategies to address pediatric survivorship care. Twenty-seven published studies looked at interventions to address disparities and decrease barriers to care, Mobley said.
“We only found 27 studies that evaluated the effectiveness of these strategies, and most of the studies focused on addressing barriers at the patient level through education-based interventions,” she said. “Only a few studies evaluated strategies for overcoming barriers at the provider level.
“We are excited to let you all know that we’re in the process of publishing [manuscripts] from this technical brief,” she added. “So, definitely stay on the lookout for those.”
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Mobley E, et al. Presented at: Cancer Center Survivorship Research Forum (virtual meeting); April 15-16, 2021.
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