Despite Medical Advances, Global Disparities Persist in Cancer Care

Brielle Urciuoli

New targeted therapies and immunotherapy treatments have rapidly improved the outcomes of patients with cancer. But not everyone is so lucky to have access to these agents.

Patients of lower socioeconomic status or are from developing countries often face barriers to care, be it the newest treatment regimen or enrolling in a clinical trial, according to Gilberto Lopes, M.D., medical director for International Programs at Sylvester Comprehensive Cancer Center at the University of Miami School of Medicine.

In the United States, African American patients have the highest death rates for colorectal and lung cancer, according to the National Cancer Institute. Meanwhile, in Brazil, there has been a decline in lung cancer mortality among men who live in the state capitals. However, lung cancer-related death rates actually went up for those who lived in smaller cities.

“In countries outside of North America and Western Europe, access is an even greater issue and a small minority of patients receive targeted agents and immunotherapy,” Lopes said in an interview with OncLive, a sister publication of CURE, at the 5th Annual Miami Lung Cancer Conference on March 10.

Lopes mentioned that lack of insurance is one of the largest barriers to care. Not to mention, minority patients in the United States are less likely to undergo molecular testing – which could be crucial in determining a successful treatment plan – and less likely to participate in clinical trials. Patients on Medicaid were reported to have worse outcomes, and for patients who are already struggling financially, a larger copay tends to mean they are less likely to follow treatment scheduling and protocols.

While most of these issues can hinder the outcomes of a person with any disease, lack of access to molecular testing and immunotherapy can be especially detrimental to someone with a lung cancer diagnosis, Lopes said.

“In the United States, we need to make sure that all patients have access to health care,” Lopes said, mentioning that this is something that people who live in rural areas often struggle with.

In low-resource settings, it is crucial to improve access to health care, smoking cessation, CT scans, treatment – including targeted therapy, surgery and immunotherapy – and clinical trial participation, he added.

But these efforts should not stop at the United States.

Currently, at Sylvester Comprehensive Cancer Center at the University of Miami, health care professionals like Lopes are working to improve cancer registries, prevention and treatments in Latin America and the Caribbean.

But still, as new treatments continue to emerge, the price of cancer care will continue to rise.

“With increasing costs, patients often can’t bear their copays, and it is important that health systems take that into consideration when treating patients,” Lopes said.

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