Clinical Cancer Advances 2021: ASCO's Report on Progress Against Cancer highlights the most important clinical research advances of the past year and identifies priority areas where ASCO believes research efforts should be focused moving forward. This year's report also discusses the critical issue of health equity in cancer research and solutions to ensure that every patient with cancer, everywhere, can access the latest advances. Achieving Equity in Cancer ResearchOverall cancer mortality has decreased in the United States 1 thanks to tremendous progress in cancer prevention, early detection, and treatment-underpinned by decades of research progress. 2 Unfortunately, not all individuals with cancer have benefited equitably from this success, as Blacks, 3 patients living in rural areas, 4 populations with lower income and education levels, 5 and others continue to experience lower survival and higher mortality rates for many cancers.As clinicians, we are committed to providing evidenced-based, high-quality cancer care to every patient, every day, everywhere. But, if clinical trials don't represent the individuals we treat, including those from racial, ethnic, and other minority populations, the state of science suffers, and patients with life-threatening conditions may not receive the best-perhaps only-treatment option for their condition.

Transgender and gender nonconforming (TGNC) individuals face significant marginalization, stigma, and discrimination. Under-reporting of TGNC individuals is common since they are often unwilling to self-identify. Meanwhile, the rapid adoption of electronic health record (EHR) systems has made large-scale, longitudinal real-world clinical data available to research and provided a unique opportunity to identify TGNC individuals using their EHRs, contributing to a promising routine health surveillance approach. Built upon existing work, we developed and validated a computable phenotype (CP) algorithm for identifying TGNC individuals and their natal sex (i.e., male-to-female or female-to-male) using both structured EHR data and unstructured clinical notes. Our CP algorithm achieved a 0.955 F1-score on the training data and a perfect F1-score on the independent testing data. Consistent with the literature, we observed an increasing percentage of TGNC individuals and a disproportionate burden of adverse health outcomes, especially sexually transmitted infections and mental health distress, in this population.

IntroductionPhysicians recognize the importance of clinical documentation for accuracy of coding and billing, but it is emphasized little in residency curricula, with an even smaller emphasis on oncology-specific documentation. We developed an educational curriculum to teach residents about clinical documentation for cancer patients. Our tool kit includes didactics, simulated history and physical (H&P) documentation, and personal feedback.MethodsA preintervention survey was first administered to gauge baseline knowledge. A simulated H&P was developed that required participants to complete their own assessment and plan. We delivered a 25-minute lecture regarding billing and coding along with documentation tips and tricks specific to hematology/oncology. Thereafter, we handed out a second H&P, and participants had to once again complete their own assessment and plan. These H&Ps were graded by three reviewers using a rubric. We then gave residents personalized feedback using the above data and administered a postintervention survey.ResultsThe postintervention survey revealed that 100% of the residents surveyed found this activity helpful, 83% noted that further knowledge of diagnosis codes was helpful to their learning, 100% noted that that this activity taught them to improve documentation, 91% said they were more likely to use cancer-specific diagnoses, and 91% said they would benefit from direct feedback-based education.DiscussionDidactic and formal education is more effective when combined with hands-on examples and direct personalized feedback.

Objective To examine factors associated with cancer patients’ satisfaction using telehealth during COVID-19, including video conferencing platforms and secure messaging systems. Method Patients with cancer participated in a cross-sectional, web-based survey was conducted with patients with cancer. The survey included questions about satisfaction with video-conferencing and secure messaging platforms to interact with clinicians during the COVID-19 pandemic. Logistic regression analyses were conducted to examine predictors of satisfaction for each telehealth platform. Results Participants generally reported positive satisfaction with each telehealth platform. Both platforms were commonly used to review medical results and discuss symptoms or treatment. Participants identifying as a man were most satisfied with their video-conferencing session, especially if they had a comfortable place to sit. Patients were more satisfied with secure messaging because they could ask a question without scheduling an appointment. Discussion When strategically used together, video-conferencing platforms and secure messaging may increase patient satisfaction in cancer care during the remainder of the pandemic and beyond. Attention must be paid to optimizing factors that promote satisfaction for each telehealth platform.