By: Adrian K. Barfield, Cancer Disparities Advocate
The San Antonio Breast Cancer Symposium (SABCS) and American Society of Hematology (ASH) should both be commended for the focus on Healthcare Disparities during the 2022 Annual meetings.
It has been well known that despite the slightly lower incidence, the mortality rate of Black women has been significantly more than white women in the United States. The factors influencing these outcomes are still being carefully uncovered; however, the solution begins with an open and honest dialogue about cancer disparities. The 2022 SABCC had several sessions on this topic, including a feature session with Maimah Karmo, Tigerlily foundation founder, who had to fight to get a biopsy to confirm a malignant cancer in her breast as a 31-year-old female of color. Unfortunately, stories of this nature are not uncommon, and many women are suffering without a trusted healthcare provider/patient partnership and easy access to credible information.
The American Society of Hematology (ASH) held its meeting on December 10-13, 2022, in New Orleans. ASH has been vocal on Diversity, Equity, and Inclusion, and most researchers are aware of the ASH statement addressing diversity, equity, and inclusion in hematology research, practice, and training (https://www.hematology.org/advocacy/policy-news-statements-testimony-and-correspondence/policy-statements/2021/ash-statement-addressing-diversity-equity-and-inclusion-in-hematology-research-practice-and-training). In addition to the ASH position statement, the minority recruitment initiative is an impressive effort to strengthen minority participation in ASH initiatives. This year’s meeting did not have an abundance of sessions on factors impacting outcomes of specific minority populations; however, the Ken Anderson chaired session on Underrepresented minorities in Clinical Trials for Hematologic Malignancies: What’s the data on the Data? Was a session worth noting? This session was anchored in multiple myeloma, a condition that is much more prevalent in Black than White individuals.
The clinicians in attendance at the meeting felt like the meeting included several studies which are likely to be practice-changing, including the data related to mantle cell lymphoma and Paroxysmal Nocturnal Hemoglobinuria (PNH). Additionally, several products on the market, including Ibrutinib and Zanubrutinib, continue to prove effectiveness in more patient populations. The science at the meeting, which is historically the case at ASH, was excellent; however, the meeting, as it related to disparities, seemed to be light. ASH continued with the listening sessions, which began after heightened awareness of disparities following some of the more recent killings of African Americans by police officers in the United States. After attending, “I left wondering if anything would change following the sessions,” stated Dr. Rhemu Birhiray of Indianapolis. There were not any obviously visible members of the ASH leadership team in attendance and documenting the suggestions. Dr. Birhiray is a strong advocate for the development of a scoring system to help keep researchers and clinicians accountable and aware of the importance of including all populations in clinical trials. “I would like to see a scoring system which takes into consideration diversity in clinical trials, and investigators should be required to report the ethnicity of patients enrolled in clinical trials.”
The San Antonio Breast Cancer Symposium (SABCS) and American Society of Hematology (ASH) will both play a major role in changing the landscape and outcomes for patients who are diagnosed with various malignancies. Shining light on the obvious barriers and bringing awareness to differences in outcomes is an important first step. Societies have a real opportunity to impact research behaviors with the adoption of scoring or implementing strict research guidelines related to the selection of research to be presented at the Annual meeting. Societies, such as ASH, “have more power than what is projected,” says Birhiray.