Story 01
Summary
The inconsistent collection of sexual orientation and gender identity (SOGI) data is a major impediment to addressing barriers to cancer prevention, early detection, treatment, and survivorship care in sexual and gender minority (SGM) populations.
Current State
SGM populations have not benefited equally from advances in cancer research and clinical care. Key barriers include the limited availability of culturally tailored prevention strategies, low uptake of screening modalities, and insufficient access to high-quality cancer care. Overcoming these barriers requires research that accurately identifies SGM populations and specific subgroups, such as transgender and intersex individuals.
Strategy
Support deliberate and strategic efforts to increase the representation of all populations in cancer research and ensure that every person benefits equitably from cancer research and clinical advancements.
DCCPS Contribution
Recognizing an opportunity to improve cancer outcomes for SGM populations, often referred to as LGBTQ+ outside the research context, DCCPS formed an SGM Interest Group to address underrepresentation of these populations in research. The group immediately began addressing the major impediment to inclusiveness, which is the inconsistent collection of SOGI data. These inconsistencies arise both from a failure to ask individuals to provide this information and the use of different measures such that it is difficult to compare results across different studies. To address the failure to ask individuals, the group supplemented cancer center support grants to support a range of efforts to implement or expand SOGI data collection in clinical settings where patients are offered the opportunity to participate in research. Simultaneously, the group, in collaboration with the National Institutes of Health (NIH) Sexual and Gender Minority Research Office, promoted the use of SOGI measures recommended to NIH by the National Academies of Sciences, Engineering, and Medicine. This included educating colleagues across NCI about the existence of these questions, promoting their use in national meetings of the research community and individual meetings with scientists, and developing language for use in notices of funding opportunities. Additional ongoing efforts include assembling the results of the supplemental activities into a compendium, expanding our understanding of SOGI measure use and plans among other cancer treatment sites, and continuing the empirical development of appropriate SOGI measures.
Story 02
Summary
Rural cancer control efforts focus on research that can make the greatest impact on reducing the cancer disparities experienced by those living in rural America across the cancer continuum.
Current State
Despite the progress made in reducing cancer incidence and mortality over the last few decades, not all people have benefited equally, and there is a need to understand how rural populations defined by demographic factors and social determinants of health continue to suffer disproportionately from cancer.
Investments in rural cancer control research increased tenfold over the past 8 years.
Strategy
Support deliberate and strategic efforts to increase the representation of all populations in cancer research and ensure that every person benefits equitably from cancer research and clinical advancements.
DCCPS Contribution
Over the last decade, DCCPS has invested in understanding, developing, testing, and implementing approaches to cancer prevention, control, and care delivery that can ameliorate rural cancer disparities. Partnering with numerous federal agencies, such as the Health Resources and Services Administration, the US Department of Agriculture, and the Centers for Disease Control and Prevention, has been invaluable for understanding the needs of rural communities to enhance research capacity and advance rural cancer control research and intervention implementation simultaneously. DCCPS has led funding opportunities, varying from supplements to NCI-Designated Cancer Centers focusing on rural partnerships to increase research capacity, full-scale research projects centering on improving the reach and quality of cancer care in rural areas, and research projects addressing the modifiable social and behavioral cancer risk factors affecting rural populations. Awarded research projects span the cancer control continuum, with many of the awards being multilevel intervention studies with deep community partnerships. The awards address topics from prevention and screening to genetic counseling, patient navigation, supportive care, financial navigation, survivorship, and end-of-life care. Our agenda remains focused on offering unique funding opportunities that enable research to be implemented at the health care delivery level quickly to address rural clinical needs. Prioritizing research that examines the intersectionality of cancer risk and mortality with individual, cultural, community, and structural factors will provide insight on the unique context of rural individuals’ lives, which can lead to appropriate multilevel intervention development and implementation to help reduce the burden of cancer experienced by rural populations.
Story 03
Summary
The NCI Office of Cancer Survivorship, in collaboration with other DCCPS programs, NCI divisions, and NIH institutes, supports innovative health equity and health disparities research to enhance the quality and length of survival of all persons diagnosed with cancer.
Current State
Ending cancer as we know it for all people requires identifying and adopting ways to engage diverse populations as participants in research while eliminating barriers to quality preventive care, screening, and cancer treatment.
Strategy
Support deliberate and strategic efforts to increase the representation of all populations in cancer research and ensure that every person benefits equitably from cancer research and clinical advancements.
DCCPS Contribution
All cancer survivors should have the opportunity to achieve their highest level of health possible, also known as health equity. Unfortunately, there are obstacles to health that can affect where and how cancer survivors live, grow, learn, work, play, worship, access care, and age. These barriers can create differences in health care utilization, quality of care, and health outcomes, also known as health disparities.
The NCI Office of Cancer Survivorship, in collaboration with other divisions, programs, and offices of NCI and NIH, supports innovative health equity and health disparities research. In a recent portfolio analysis published in the Journal of the National Cancer Institute, DCCPS authors identified NIH-funded survivorship grants focused on populations experiencing health disparities, as well as opportunities for future research.
From the analysis, DCCPS authors have identified gaps in funded research on specific populations, cancer types, and focus areas of survivorship science. There is an opportunity for further survivorship research to include more cancer survivors from sexual and gender minority populations, American Indian and Alaska Native populations, and Native Hawaiian and other Pacific Islander populations. Additionally, there is a need to address the neighborhood-built environment and societal-level factors that drive unfair differences in health outcomes.
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