Increasing Access to Clinical Cancer Trials and Emerging Technologies for Minority Populations: The Native American Project

Petereit, Daniel G.; Rogers, Deborah; Govern, Frank; Coleman, Norman; Osburn, Christen H.; Howard, Steve; Kaur, Judith S.; Burhansstipanov, Linda; Fowler, C. Jack F.; Chappell, Richard J.; Mehta, Minesh P.

doi:10.1200/jco.2004.01.119

Cited by 43 publications

(57 citation statements)

References 13 publications

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“…This would be a distinct advantage for patients who live far away from radiation oncology facilities, thus constituting both a more practical and economical means of providing RT. Hypofractionation in this setting has been recently reported in the literature (6).…”

Section: Introductionmentioning

confidence: 95%

Late Outcomes Following Hypofractionated Conformal Radiotherapy vs. Standard Fractionation for Localized Prostate Cancer: A Nonrandomized Contemporary Comparison

Leborgne

Fowler

2009

International Journal of Radiation Oncology*Biology*Physics

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Section: Introductionmentioning

confidence: 95%

Late Outcomes Following Hypofractionated Conformal Radiotherapy vs. Standard Fractionation for Localized Prostate Cancer: A Nonrandomized Contemporary Comparison

Leborgne

Fowler

2009

International Journal of Radiation Oncology*Biology*Physics

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“…Because of the limited availability of cooperative group trials as noted above, the grantees used two approaches to expand protocol participation: (1) development of PI-initiated clinical trials targeting stage of disease and/or including shorter radiation therapy schedules to address patients’ transportation or accommodations barriers (7, 8) and (2) expanding access to other NCI-sponsored clinical trials beyond radiation oncology, to include surgical/medical oncology trials (Table 2). This expansion was facilitated starting in 2006 by Clinical Trial Operating Committee (CTOC) supplemental awards to RCRH, SRHS, and UPMC McKeesport for hiring clinical staff interacting with other oncology specialists and resulted in increased annual patient accruals (Table 2).…”

Section: Resultsmentioning

confidence: 99%

National Cancer Instituteâ€™s Cancer Disparities Research Partnership Program: Experience and Lessons Learned

et al. 2014

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Purpose: To increase access of underserved/health disparities communities to National Cancer Institute (NCI) clinical trials, the Radiation Research Program piloted a unique model – the Cancer Disparities Research Partnership (CDRP) program. CDRP targeted community hospitals with a limited past NCI funding history and provided funding to establish the infrastructure for their clinical research program.Methods: Initially, 5-year planning phase funding was awarded to six CDRP institutions through a cooperative agreement (U56). Five were subsequently eligible to compete for 5-year implementation phase (U54) funding and three received a second award. Additionally, the NCI Center to Reduce Cancer Health Disparities supported their U56 patient navigation programs.Results: Community-based hospitals with little or no clinical trials experience required at least a year to develop the infrastructure and establish community outreach/education and patient navigation programs before accrual to clinical trials could begin. Once established, CDRP sites increased their yearly patient accrual mainly to NCI-sponsored cooperative group trials (~60%) and Principal Investigator/mentor-initiated trials (~30%). The total number of patients accrued on all types of trials was 2,371, while 5,147 patients received navigation services.Conclusion: Despite a historical gap in participation in clinical cancer research, underserved communities are willing/eager to participate. Since a limited number of cooperative group trials address locally advanced diseases seen in health disparities populations; this shortcoming needs to be rectified. Sustainability for these programs remains a challenge. Addressing these gaps through research and public health mechanisms may have an important impact on their health, scientific progress, and efforts to increase diversity in NCI clinical trials.

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“…However, some models exist such as Walking Forward, discussed below, that have reached out to these communities with “on site” navigators and telemedicine to mitigate these geographic barriers. 9 …”

Section: Health Behaviors Cancer Risk and Cancer Preventionmentioning

confidence: 99%

“…2021 This is in part related to the fact that AI/ANs are more likely to have advanced-stage cancer at the time of their cancer diagnosis. 97, 22,23 However, there are also notable differences in cancer care processes for AI/AN populations when compared to non-AI/AN populations. Studies of national samples have shown that a relatively lower proportion of AI/ANs receive cancer-directed therapies after cancer diagnosis than non-Hispanic Whites, and, not surprisingly, this is likely related to socioeconomic indicators such as lower income and rural residence.…”

Section: Access To Optimal Cancer Treatmentmentioning

confidence: 99%

“…6,7 Cancer is the second leading cause of death among AI/ANs nationwide, 8 and disproportionately presents at advanced stages for AI/ANs who are diagnosed with the disease. 910 However, per capita funding for the Indian Health Service, the primary system through which many AI/ANs access their health care, was $3099 in 2015 compared to $8097 for the US general population. This perennial underfunding of the US trust responsibility to provide health care to AI/ANs for all health-related needs sets up particular challenges and the need for innovative approaches for providing the highly-coordinated and multidisciplinary care necessary for affecting optimal cancer outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Cancer Care Access and Outcomes for American Indian Populations in the United States: Challenges and Models for Progress

Guadagnolo

Petereit

Coleman

2017

Seminars in Radiation Oncology

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Background Low socioeconomic and health care access realities of being American Indian/Alaskan Native (AI/AN) in the US combined with decades of data documenting poor cancer outcomes for this population provide a population nested within the US that is analogous to the cancer care landscape of low and middle income countries (LMICs)internationally. Methods We reviewed the medical literature with respect to cancer prevention, access to cancer treatment, and access to effective supportive and palliative care for AI/AN populations in the US. Results Research confirms poorer cancer outcomes, sub-optimal cancer screening, and high-risk cancer behaviors among AI/AN communities. AI/AN cancer patients are less likely to undergo recommended cancer surgeries and adjuvant chemotherapy and radiation therapy than their white counterparts. Studies including both rural and urban AI cancer survivors revealed barriers to receipt of optimal cancer symptom management and proportionally lower hospice utilization among AI/AN populations. Culturally-tailored programs in targeted communities have been shown to mitigate the observed cancer-related health disparities among AI/AN communities. Conclusions There is still much work to be done to improve cancer-related health outcomes in AI/AN communities, and the goals of the providers serving them corresponds with those propelling the growing interest in global oncology equity. Policy work and more funding are needed to continue to build upon the work that the Indian Health Service and established cancer-related health programs have begun in AI/AN communities.

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Increasing Access to Clinical Cancer Trials and Emerging Technologies for Minority Populations: The Native American Project

Cited by 43 publications

References 13 publications

Late Outcomes Following Hypofractionated Conformal Radiotherapy vs. Standard Fractionation for Localized Prostate Cancer: A Nonrandomized Contemporary Comparison

Late Outcomes Following Hypofractionated Conformal Radiotherapy vs. Standard Fractionation for Localized Prostate Cancer: A Nonrandomized Contemporary Comparison

National Cancer Instituteâ€™s Cancer Disparities Research Partnership Program: Experience and Lessons Learned

Cancer Care Access and Outcomes for American Indian Populations in the United States: Challenges and Models for Progress

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