LCI research at ASH 2019 advances racial equity in cancer care
By Bei Hu, MD and Nilanjan Ghosh, MD, PhD
Atrium Health’s Levine Cancer Institute (LCI) presented 30 studies on blood cancers and blood disorders at the American Society of Hematology (ASH) Annual Meeting last month. Our study, which was selected out of thousands for the ASH press program, shows how LCI’s care model is raising the standard of care for underserved patients.
After comparing survival or disease progression in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), our study found no significant differences between outcomes for white and non-white patients after at least two years of follow up. The findings contrast with previous population-based studies showing poorer outcomes for racial minorities who receive treatment for lymphoma. What accounted for this difference? A set of interventions designed to counteract socioeconomic barriers that disproportionately affect minority patients.
As a safety net provider, LCI serves one of the most racially and economically diverse patient populations of any large cancer center in the U.S. Among the non-white patients in our study, 73% identified as African American, 15% identified as Hispanic, 10% identified as Asian and 2% identified as another ethnicity. Our results show that when non-Caucasian patients and Caucasian patients received equal access to patient navigation, stem cell transplantation and clinical trials, their outcomes were similar. At the end of our study, African American and Hispanic participants experienced similar rates of overall and progression-free survival despite having lesser insurance coverage.
A key feature of LCI’s patient support is a patient navigator program consisting of more than 30 specially trained oncology nurses, who work with each patient to overcome any barriers to their care.
Our navigators provide hands-on support to coordinate all aspects of care and help patients stay on track with their appointments and treatment. Disease-specific navigators also work with physicians to make the delivery of care more efficient and capture outcomes data for research and quality improvement.
Among all patients enrolled in our study, 85% utilized LCI’s patient navigation program. Support for high-need patients was extensive – including lodging for homeless patients, transportation for patients without a car, and frequent communication with primary care physicians and specialists. By making patient navigation our standard of care, we can offer a trustworthy and consistent presence to help patients understand an increasingly complex healthcare environment. LCI is also proud to host a Patient Navigator Academy – one of the first of its kind in the nation.
When we examine racial disparities in cancer care, it’s critical to understand whether they stem from differences in disease biology, or whether they can be influenced by the type of care patients receive. The study we presented at ASH 2019 showed that disease biology was similar between Caucasians and non-Caucasians, and provider interventions within our institution could overcome racial and socioeconomic factors in determining a patient’s response to DLBCL treatment. That’s a strong affirmation of the power of patient support programs to promote equity in cancer care.
We believe that every patient should have access to a full range of cancer care options. Often that means looking outside the exam room to address social barriers that can impede patient care. In the coming months, we plan to expand our analysis to evaluate more aspects of our patient navigator program, including its ability to increase car access among high-need patients, especially those outside major cities.
To connect with one of our lymphoma specialists or to refer a patient, call 980-442-6819. To learn more about our patient navigator program, download our informational brochure.