Addressing disparities and challenges in underserved patient populations with metastatic breast cancer in Europe

Abstract

People with metastatic breast cancer face many challenges and disparities in obtaining optimal cancer care. These challenges are accentuated in underserved patient populations across Europe, who are less likely to receive quality healthcare for reasons including socioeconomic inequalities, educational or cultural status, or geographic location. While there are many local and national initiatives targeted to address these challenges, there remains a need to reduce disparities and improve access to healthcare to improve outcomes, with a focus on multidisciplinary stakeholder engagement. In October 2019, a range of experts in metastatic breast cancer, including healthcare professionals, patient representatives, policymakers and politicians, met to discuss and prioritize the critical needs of underserved patient populations with metastatic breast cancer in Europe. Six key challenges faced by these communities were identified: the need for amplification of the metastatic breast cancer patient voice, better and wider implementation of high-quality guidelines for metastatic breast cancer, more collaboration between stakeholders, tailored support for patients from different cultural and ethnic backgrounds, improved data sharing, and work-related issues. The Expert Panel then conceived and discussed potential actionable goals to address each key challenge. Their conclusions present a set of interrelated approaches to address the different challenges and could serve as the basis for concerted improvement of the lives of patients with metastatic breast cancer in Europe.

Addressing racial/ethnic disparities in cancer clinical trials: Everyone has a role to play

“…Participation in clinical trials itself may ameliorate observed disparities in cancer outcomes, because clinical trials can provide access to evidence‐based medicines 58,59 . Achieving cancer health equity through optimizing diversity in clinical trials is a national and global imperative, and everyone has a role to play 24,36,60 …”

“…58,59 Achieving cancer health equity through optimizing diversity in clinical trials is a national and global imperative, and everyone has a role to play. 24,36,60…”

Challenges in Diversity, Equity, and Inclusion in Research and Clinical Oncology

“…Among patients with advanced breast cancer there are a number of challenges that contribute to disparities in outcomes among underserved patient populations. Such disparities have been classified at the level of the individual or at a healthcare system level in a recent pan-European study that convened an expert panel ( 12 ). A number of challenges faced by underserved patient populations were identified including awareness, issues with communication, cultural factors, issues with data collection and clinical trial participation, issues with implementation of high-quality guidelines, and some workplace issues ( 12 ).…”

“…Such disparities have been classified at the level of the individual or at a healthcare system level in a recent pan-European study that convened an expert panel ( 12 ). A number of challenges faced by underserved patient populations were identified including awareness, issues with communication, cultural factors, issues with data collection and clinical trial participation, issues with implementation of high-quality guidelines, and some workplace issues ( 12 ). Coordinated efforts, including cooperation between countries, to address the challenges that lead to healthcare disparities among patients with metastatic breast cancer could improve outcomes and reduce disparities among the underserved patient populations ( 12 ).…”

Advancing Breast Cancer Advocacy in Eastern Europe and Central Asia: Findings From Women’s Empowerment Cancer Advocacy Network (WE CAN) Summits

“…Survivor- and oncologist-led cancer CSOs were established to fill gaps in public health care systems and worked to lift stigma of cancer as a death sentence, improve early detection, and increase access to cancer treatment and psychosocial support. 17 – 19 A deeper understanding of experiences and priorities of breast cancer CSOs in the region has the potential to help patient advocates and oncologists to improve cancer care. 20 – 24 …”