Advancing DEI in the Cancer Workforce: A Policy Summit

On September 10, the National Comprehensive Care Network hosted a policy summit in Washington, District of Columbia, focused on advancing diversity, equity, and inclusion (DEI) in the cancer workforce. The summit brought together a diverse group of stakeholders to engage in meaningful discussions about strategies and policies to promote DEI within the field. The agenda featured an overview of the current cancer workforce, highlighted the benefits of diversity across all roles, and explored effective policies and practices to enhance workforce diversity and address disparities in cancer care.

Tiffany Wallace, PhD, branch director, Disparities Research Branch, National Cancer Institute Center for Cancer Health Equity, delivered the keynote address to open the summit, emphasizing the critical importance of diversity in cancer care. “There is a lot of data showing that diversity is absolutely critical for solving complex health challenges,” Dr. Wallace stated. “People representing distinct backgrounds publish more widely cited research, generating improved science and leading to greater discoveries.”

DEI in cancer care is essential for ensuring that all patients receive high-quality, personalized treatment and support. A diverse workforce brings a variety of perspectives and experiences that can enhance understanding of patients’ unique cultural backgrounds and health needs. Prioritizing DEI not only improves patient comfort and trust but also leads to more effective communication and engagement in care. Moreover, inclusive practices help address disparities in treatment outcomes by ensuring that underrepresented communities have access to clinical trials and comprehensive care. By fostering an environment where every voice is heard and valued, the cancer care sector can drive innovation and improve overall health outcomes for all individuals affected by cancer.

Facets of DEI in the Oncology Workforce

Following Dr. Wallace’s address, panelists were invited to speak on strategies to establish and prioritize a culture of DEI in their organizations and institutions. The panelists were  Terrance Mayes, EdD, associate dean for Equity and Strategic Initiatives, executive director, Commission on Justice and Equity, Stanford University; Rodney Tucker, MD, MMM, associate director for Access, Belonging, and Culture, O’Neal Comprehensive Cancer Center at UAB Medicine; Lauren Wall, MSc, senior director, Cancer Clinical Trials Support Office, The University of Chicago Comprehensive Cancer Center; Danielle Mitchell, CEO/founder, Black Women in Clinical Research; and Amy Garrett, DrPH, MA, ACRP-CP, associate principal scientist, Oncology Clinical Operations, Merck & Co, Inc. The panel was moderated by Clifford Goodman, PhD, consultant, Health Care Technology and Policy. Dr. Mayes argued, “The labels don’t matter so much, but the language does matter. The first thing we need to do is separate the diversity from the equity from the inclusion. They are different and require a different approach.” He also expressed that, now more than ever, it is important to think through and understand the intention around the work.

Central to the conversation about promoting DEI in the workplace is the impact of language on employee feelings, as highlighted by Dr. Garrett. “[We need to create] workforces that include a psychologically safe workspace that allows people to feel comfortable expressing their concerns and share their ideas without feeling fearful,” he noted.

Dr. Tucker elaborated on the advantages of prioritizing DEI. “When everyone in the health workforce looks diverse, patients are comfortable. [They think, ‘If] they look like me, they may have some of the same lived experiences’,” he said.

“Diverse staff recruit diverse patients.” – Danielle Mitchell

Wall agreed and added, “DEI helps with recruitment and retention, too. Organizations that have equitable practices and create an environment of diversity are more successful in attracting and keeping talent.

Dr. Goodman raised the important question of how to foster open communication with the community in a comfortable setting. Mitchell acknowledged this challenge, suggesting that communities should leverage familiar spaces – like barbershops and churches – to promote dialogue and increase awareness. She emphasized that many community members have unanswered questions and need opportunities to voice them in environments where they feel at ease.

“An organization is only as strong as its people. DEI needs to be in the center from the beginning,” Dr. Garrett stated. “Turnover is expensive and causes delays and impacts innovation. How do we bring the best and brightest talent to our organization and how do we keep them here? Executive leadership must define, articulate, and hold themselves and others accountable for DEI,” added Dr. Mayes. Wall further commented that when an organization prioritizes DEI and leadership ingrains it in what they do every day, it trickles down. “The sign of success is when people ask questions or have arguments or disagree in a safe space,” Dr. Tucker noted.

The Role of Culture

The panel also addressed the evolving state and federal policies that may affect their DEI strategies. Mitchell discussed the mixed reactions to the recent US Food & Drug Administration (FDA) guidance on DEI in clinical trials, stressing the need for a clearer breakdown of FDA guidance for researchers. Dr. Garrett concurred, suggesting that increasing diversity and equity in clinical trials requires proactive engagement, such as attending tribal council meetings and volunteering within community organizations to gain a deeper understanding of their cultures and perspectives on cancer care and research. Raising awareness must be a priority in underserved communities, acknowledging that clinicians can only provide appropriate care if they actively seek input from community members about their needs.

Remaining Barriers

The growing divisiveness and demonization of DEI language is hindering progress toward important goals, according to Dr. Tucker. He added that the focus should not be solely on language itself, but rather its intention. Wall commented that organizations need to invest in effective HR practices and recruitment efforts, noting that not everyone allocates sufficient resources to this area. Stronger and more frequent collaboration are also a necessity to break down silos among agencies and institutions, Dr. Garrett said. “We have an opportunity to better coordinate and collaborate across the country; we are stronger together than we are apart.”

This discussion deeply aligns with the 2024-2025 ACCC president’s theme, Reimagining Community Engagement and Equity in Cancer. President Nadine Barrett, PhD, MA, MS, issued a compelling call to action for the community to continue progressing toward equity in cancer care.

Read Part 2 of this blog series, which will cover the summit’s best practices in DEI presentations and feature a panel focused on navigating the policy landscape to enhance DEI in cancer care.