Baby Boomer oncologists less likely to identify racial bias in cancer care
Key takeaways:
- Just over one-half of Baby Boomer oncologists perceive racial disparity as moderate to very high.
- Researchers recommend oncologists identify their own triggers of racial anxiety and unconscious bias.
Compared with Baby Boomers, Millennial and Gen X oncologists are far more likely to believe that moderate to high levels of racial disparities exist in cancer, study results revealed.
Additionally, nearly half of oncologists perceived very high to moderate levels of racial anxiety or unconscious bias from white providers to non-white patients, according to research published in Journal of the National Comprehensive Cancer Network.
“We aimed to assess self-reported perceptions of racial disparity, racial anxiety and unconscious bias at oncology practices and their associated adverse influences on non-white patients,” Alexandrina Balanean, MPH, lead publications scientist of strategic research at Cardinal Health, and colleagues wrote. “We found the most significant differences by generational age group, followed by racial/ethnic group. Notably, a persistent inverse correlation emerged between increasing age and decreasing levels of perception.
“Additionally, perception was statistically significantly higher in non-white than white oncologists,” they added.
Background, methods
Disparities in cancer care exist because of the impact of demographic and socioeconomic variables, according to background information provided by study investigators. Moreover, the impact of cancer is not equal, with certain structural discrimination causing worse outcomes for some individuals due to income, race and zip code. For example, Black patients less often receive timely treatment or receive certain referrals to clinical trials or genetic testing compared with white patients.
Researchers administered a survey to 369 oncologists to measure the difference in perception regarding racial disparity, racial anxiety, and unconscious bias and adverse influence on clinical interactions, treatment and outcomes among non-white patients with cancer.
They analyzed responses via generational age group, sex/gender, race/ethnicity, region of residence and selection of “decline to respond.”
Results, next steps
The most significant differences among perceptions of racial disparity, racial anxiety and unconscious bias occurred by age group, followed by race/ethnicity.
Researchers reported that 84% of millennial oncologists, 69% of Gen X oncologists and 57% of Baby Boomer oncologists perceived racial disparity as moderate to very high in clinical practice; Baby Boomers appeared to be 86% more likely than millennials and 63% more likely than Gen X oncologists to perceive low/nonexistent levels of racial anxiety or unconscious bias.
A noted discrepancy between 62% of oncologists perceiving moderate to very high levels of racial anxiety or unconscious bias and 37% associating them with adverse influence on non-white patients shows an apparent disconnect, according to researchers, particularly among oncologists of the Baby Boomer generation.
Researchers noted that oncologists working to better understand their personal perceptions of the topics included in the survey would positively impact patient-provider communication and improve outcomes.
“The social construct of race still pervades oncology; disease nomenclature, screening/treatment guidelines and clinical decision algorithms remain extensively based on data from white patients,” researchers wrote. “Rather than stifling discussions surrounding these issues by lacking insight or denying their existence, everyone in the oncology workforce should uncover their own levels and triggers of racial anxiety or unconscious bias and modify their behaviors accordingly. It is this simple — and this complicated.
“Until we understand the full spectrum of ancestral, biologic, clinical, environmental, epigenetic, genomic, social and systemic factors catalyzing cancer in diverse patient populations, cancer will continue burdening disproportionately and afflicting indiscriminately,” they added. “Cancer care should not discriminate either.”
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