The new National Comprehensive Cancer Network (NCCN) forum on equity aims to improve diversity of clinical staff representation across the nation’s leading academic cancer centers.
This week, the National Comprehensive Cancer Network (NCCN) announced the appointment of a chair and vice-chair to lead its new Diversity, Equity, & Inclusion (DEI) Directors Forum.
Terrance Mayes, EdD, associate director for DEI at the Stanford Cancer Institute, and Loretta Erhunmwunsee, MD, FACS, thoracic surgeon and an assistant professor in the Division of Thoracic Surgery, City of Hope National Medical Center, respectively, will serve as chair and vice-chair and join more than 20 experts on DEI in health care from leading academic cancer centers across the United States that comprise the NCCN.
“I am honored to serve as the inaugural chair of the NCCN DEI Directors Forum at such a pivotal time in our nation. The last several years have drawn into sharper focus the role that structural discrimination has played within the United States health care system,” said Mayes, in an accompanying press release.
“As a health care community, we have an obligation to act—I look forward to working with the NCCN DEI Directors Forum Members in advancing DEI at all levels of cancer care.”
“In order to achieve cancer health equity, cancer centers must identify and eliminate structural barriers and practices that undermine workforce DEI,” Erhunmwunsee added. “Initiatives that promote DEI must be truly prioritized by center directors and top system leadership with the appropriate funding and resourcing. Otherwise, historically excluded groups will remain marginalized. I look forward to partnering with this forum of DEI leadership as we develop and implement policy and practice initiatives that advance DEI at a national level.”
In the United States, cancer mortality risk differs significantly by race and ethnicity. Compared with White men and women, respectively, Black men and women are associated with 19% and 12% higher cancer mortality rates.
Several reasons have been linked with these disparities, including the impact of structural and interpersonal racism and social determinants of health. The inadequate representation of minority populations among health care providers—who increase trust and reduce opportunity for bias—is an additional challenge.
Data have shown that when minority patients are cared for by physicians of the same race/ethnicity, medication adherence, shared decision-making, and patient understanding of cancer risk improve.
However, racial and ethnic minorities are critically underrepresented across oncology and particularly in leadership positions. Black individuals currently represent 12.7% of the US population, but only 5% of active physicians. Moreover, Hispanic/Latino individuals make up 18.1% of the overall population, but only 5.8% of doctors. And when it comes to people in leadership positions, representation falls to 3.5% and 3.8%, respectively, for Black and Hispanic/Latino Americans.
“There are significant disparities in cancer outcomes across race and ethnicity; this is unacceptable and must be addressed urgently and thoroughly,” said Robert W. Carlson, MD, CEO of the NCCN, in the press release. “Increasing diverse representation among care providers is one overdue step toward improving the equity and quality of cancer care.”
In response to these stark disparities, the National Cancer Institute (NCI) recently announced that all centers will need to design and implement a plan to increase diversity in faculty and workforce in order to remain eligible for federal designation and funding.
The NCCN’s DEI Directors Forum will assist in providing support and resources for the development of these requirements, among other initiatives, to improve best practices in advancing equity withinn cancer care systems. The group will meet multiple times a year, both virtually and in person, to formulate recommendations for the development of new and updated policies and practices to support DEI efforts.
“Unfortunately, we have a long way to go, and the people doing this crucial work are often underfunded and overburdened,” said Carlson. “We’re happy to be able to use the NCCN’s existing infrastructure to address some of that burden. Doctors Mayes and Erhunmwunsee are tremendous leaders with a clear vision for the future. We’re honored to have them at the forefront of this forum propelling academic centers to help all people with cancer live better lives.”