Research Review 2020-2021

Informed consent is a critical phase of the study accrual process. Articles in this issue of the Research Review touch on possible areas for advancement, such as tailored education for staff and physicians on communication/delivery of informed consent information, including real-time sensitivity to language use, body language, and the patient’s status in the course of their disease.
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2020 was a difficult year. Millions struggled with COVID-19 and its impact on personal, family, and society well-being. The Black Lives Matter movement (although not new in 2020) reminded us that systemic racism translates to perpetual health disparities and societal inequities. We experienced hurricanes, derechos, wildfires, and floods. The tension and animosity associated with the U.S. Presidential Election and its aftermath is palpable, ongoing, and profoundly polarizing.
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Across the oncology ecosystem there is recognition of the importance of listening to and learning from the community’s voice whether it’s reflecting practices in care delivery or describing clinical trial barriers and challenges. In this issue, the Research Review explores how amplifying the community’s voice may help close gaps in cancer research.
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With this issue, the ACCC Research Review looks at how community oncology can begin to address a significant gap in cancer research—knowledge and information on care for sexual and gender minority (SGM) patients with cancer.
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This edition of the ACCC Research Review focuses on issues related to workforce training for cancer clinical research. Whether a cancer program is currently conducting clinical studies or is considering becoming a trial site, the bedrock on which all training rests is an understanding that oncology clinical research is unique in the sphere of medical practice.
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As we look at how community oncology can close the gap in cancer research, a critical piece of the puzzle is improving access to trials for those living in rural areas. The challenges are many: geography, health and economic disparities, a lean (or lack of) oncology workforce in many regions, trial eligibility criteria, costs, and provider bandwidth, among others.

This issue of the Research Review features interviews with oncology providers who are succeeding in making clinical trials an option for patients in rural communities.
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This issue of the ACCC Research Review provides support, perspectives, and resources for follow through on the imperative to make clinical trials more inclusive, diverse, accessible, and representative of our patient populations in communities across the country.

While this task can seem overwhelming, let us consider the fact that as oncology professionals, change drives the work we do. Improving rates of screening and early diagnosis, advancing treatments, eliminating health disparities, and reducing the burden of cancer on society—these overarching goals all demand intentional actions and sustained commitment to achieve change.
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Advancing age is the biggest risk factor for cancer. According to the National Cancer Institute, the median age at which cancer is diagnosed in the United States is 66 years. One-quarter of new cancer cases are diagnosed in people aged 65 to 74. An aging population is expanding this demographic trend. By the year 2030, 70 percent of all cancers are expected to occur in adults age 65 and older. Understanding how emerging cancer treatments affect older adults is critical for the delivery of high-quality, patient-centered care.

Yet older adults are consistently precluded from participating in clinical trials for promising new treatments. A 2019 analysis of more than 300 oncology randomized clinical trials found trial participants to be significantly younger than patients in the general population with the same tumor types. Authors of the report published in JAMA Oncology characterize the age disparity they identified as “pervasive and worsening.” In the authors’ analysis of 262,354 participants enrolled in 302 oncology clinical trials between 1994 and 2015, the median age of participants was 6.49 years younger than the median age of other patients with the same cancers.
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Clinical trials need to be more inclusive of Black and African American, Latinx, geriatric patients, and other underserved groups. Equitable representation in and access to cancer clinical trials is essential to truly closing the gap in cancer research.

ACCC has its finger on the pulse of our U.S. oncology community. Top of mind for all of us now are COVID-19, health equity, and expanding the clinical research that continues to improve oncology care for our patients. Based upon the needs and interest of our members, ACCC has selected this year’ president’s theme: Community Oncology Can Close the Gap in Cancer Research: Here’s How.
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