ASCO: Equity. Every Patient. Every Day. Everywhere.

by Cara Levinson

A year ago, I watched through tears as my city burned in the riots that came in the aftermath of the George Floyd murder. The riots and ensuing damage were devastating to Philadelphia and I prayed that the impact would lead to real, lasting focus on the racism and discrimination in our country. I was skeptical that anything would change in a meaningful way.

A year later I “attended” virtual ASCO 2021, the American Society of Clinical Oncology’s annual meeting (June 4-8, 2021.)  I was struck by how much emphasis was placed on equity. To start, the theme of the meeting was “Equity. Every patient. Every day. Everywhere.”

In the meeting opening, President Lori Pierce, MD kicked off the meeting with a focus on eliminating racial and socioeconomic disparities in cancer outcomes. She spoke of how the events of the past year have “galvanized ASCO to explicitly condemn racism, acknowledge its profound impact on public health and commit significant new volunteer and staff resources to confront it.” She pointed to the three pillars of the ASCO mission: research, education, and quality care, and gave examples of advances in all three pillars. She also acknowledged that there is still more to do – that this it is our time, our responsibility, our fight.

“We can’t leave huge portions of our society behind.”

Dr. Ned Sharpless, MD, Director of the National Cancer Institute

Dr. Ned Sharpless, MD, Director of the National Cancer Institute (NCI) also addressed the meeting. He started by exclaiming: “We can’t leave huge portions of our society behind.” He spoke about diversity, equity and inclusion and the three areas the NCI is focusing on: fostering equity and inclusivity at NCI, continuing research into cancer health disparities and focusing the research portfolio there, and ensuring diversity and inclusivity across cancer research and care organizations. The goal at all levels is promoting equity and reducing disparities.

There was also an interesting presentation by Dr. Rhea Boyd titled “An Anti-Racist Imperative for Cancer Care.”

In all, there were 37 programs during the meeting that focused on equity, ranging from equity in breast cancer to breaking barriers in clinical trials, from structural racism and cancer disparities to reappraising genetics-based theories of racial/ethnical cancer outcome disparities, and from transforming clinical trials to be more inclusive to racial inequities in survivorship.

Additionally, many of the presentations emphasized a need for equity in cancer as well, in areas such as prostate cancer, breast cancer and biomarker testing in non-small cell lung cancer.

People of color account for only 5% or less of cancer clinical trial participants.

Social media posts about #ASCO2021 highlighted both the equity and disparities in clinical trials as well, making note of facts such as “black women have highest death rates from breast cancer but make up (only) 1-3% of clinical trial participants. We need clinical trials to make advances in treatment.” and “People of color account for only 5% or less of cancer clinical trial participants.”

So, as I reflect back to the painful challenges of the past year, it resonates with me that lasting change has come in so many ways. ASCO 2021 is proof that real conversations are happening to address the inequities in healthcare. Our work has only just begun, but the commitment of the community and the honest conversations that are happening are a vital step in the right direction. I believe—if ASCO can be viewed as a microcosm of the greater discussions that are happening around healthcare—there is enough momentum that this is not just the topic of the moment, but representative of the first necessary steps to address real systemic issues in healthcare and in our society as a whole.