Future Direction: Health Equity

Selected Examples of Progress

Collecting and Exploring New Data

Data from Texas (rural), Alaska (Alaska Native), and North Dakota (American Indian) on colonoscopies conducted by non-gastroenterologists (non-GIs)—such as general surgeons, physicians, or nurse practitioners—are being analyzed to inform whether future steps should be taken to encourage colonoscopies by non-GIs in rural areas and reservations. In a joint project with the US Department of Agriculture, persistent poverty census tracts were incorporated into SEER; these data, currently being analyzed, are critical in understanding place-based poverty and the resultant disparity among Blacks and Whites in cancer survival to develop appropriate multilevel interventions. To make American Indian and Alaska Native cancer data more easily accessible to the community and researchers, Roswell Park Comprehensive Cancer Center held the first of such discussions with researchers, tribal community members, the Indian Health Service, and NCI to assess the challenges and opportunities; this discussion will be followed up with a workshop for wider audiences and the Tribal Epidemiology Centers to collect more regional data where the populations are not included in the larger data sets.

Centers for Cancer Control Research in Persistent Poverty Areas

DCCPS is awarding $50 million over 5 years to support five new Centers for Cancer Control Research in Persistent Poverty Areas as part of the Persistent Poverty Initiative (RFA-CA-22-015). The initiative aims to reduce cancer morbidity and mortality among low-income populations living in persistent poverty census tracts by conducting research studies, developing partnerships, implementing sustainable interventions with local communities, and enhancing the professional development of a cadre of early-career researchers who are well-versed in conducting cancer control and population research in underserved communities.

Advancing Cancer Control Equity Research through Transformative Solutions

DCCPS is launching the Advancing Cancer Control Equity Research through Transformative Solutions initiative, aiming to address the impact of social determinants of health (SDOH) on adverse cancer control outcomes. The initiative will fund up to four research centers and one coordinating center to develop interventions, measures, and methods that target SDOH, support community engagement, and advance cancer control equity. The earliest start date for the centers is July 2024. The goal is to promote health equity by implementing interventions that effectively tackle the multilevel pathways through which SDOH influence adverse cancer outcomes.

Planning for the Future

Looking ahead, we must increase our understanding of the role of SDOH in cancer control and population sciences. Related to the Data Strategies area, an important step would be incorporating SDOH in cancer registries through linkages and encouraging studies, especially cohorts, to link to other data sets or to collect relevant data. Another key step would be the incorporation of sexual orientation and gender identity (SOGI) measures in cancer registries and cohorts to better understand the disparities related to cancer risk and poorer outcomes experienced by SGM populations, as well as to inform the development of interventions to address those disparities. Likewise, environmental justice (e.g., air and water pollution, exposures to known and/or suspect toxins, inadequate access to healthy food and green space, and inadequate transportation) and its intersection with cancer is another area of tremendous research opportunity that aligns with the Health Equity priority area in the division.