The Radiation Oncology Institute is excited to announce four new 2020 research award winners who are taking on projects to find innovative ways to address disparities in radiation oncology. As your research foundation, the ROI works to provide practical solutions to some of the most pressing challenges for radiation oncology by supporting research on a current topic of importance. Finding ways to improve diversity and inclusion both in terms of patient care and the radiation oncology workforce is critical to advancing the field, and many in the community are eager for change. The ROI decided to focus its most recent request for proposals on the topic and partnered with the ASTRO Committee on Health Equity, Diversity and Inclusion to ensure that the highest quality research projects on the most relevant issues were selected for funding. Over $200,000 in new grants from the ROI will support the work of the following four teams of researchers.
Sara Alcorn, MD, PhD, and Crystal Aguh, MD, of the Johns Hopkins University School of Medicine will lead a team to develop a web-based tool that will objectively assess acute skin toxicity in patients with a wide range of skin tones who are receiving radiotherapy to treat breast cancer. Existing grading tools rely on subjective scoring by providers that could introduce bias and do not account for the side effects differentially experienced by people of color. This unique collaboration between the Department of Radiation Oncology and the Ethnic Skin Program in the Department of Dermatology will result in a novel grading system based on images taken with a digital camera that will be translated into colorimetric data. Prior work by the Department of Dermatology has shown that colorimetry can be used to detect changes in pigment and erythema and may be particularly useful for assessing skin in people of color. The new tool will also incorporate patient reported outcomes directly into the grading system, increasing its potential impact on quality of life from the patient’s perspective. With the award from the ROI, Dr. Alcorn and Dr. Aguh aim to create a better way to assess acute skin reactions and thus improve quality of life for patients across the range of skin tones, using a tool that will be readily available and easy to apply in standard clinical practice.
Malcolm Mattes, MD, of the Rutgers Cancer Institute of New Jersey will establish a program to increase the number of African American and Latinx medical students choosing to pursue radiation oncology. Currently, underrepresented minorities (URM) make up only 7% of the radiation oncology workforce compared to 16% of medical school graduates and 30% of the U.S. population. Greater diversity in the radiation oncology workforce can lead to increased access to care in medically under-served communities and higher treatment satisfaction among those patients. Dr. Mattes will focus on increasing awareness of the specialty at medical schools with an enrollment of at least 15% URM students that lack an affiliated radiation oncology department or residency program. The program will consist of extracurricular presentations by radiation oncologists, department tours, integration of radiation oncology concepts into medical school curricula, and mentorship to help students apply for summer research opportunities and eventually residency positions. The goal of Dr. Mattes’ ROI-funded work is to create a foundation for an enduring and wide-reaching educational structure to improve diversity in the radiation oncology workforce.
Oluwadamilola T. Oladeru, MD, MA, of the Harvard Radiation Oncology Program (Massachusetts General Hospital) will work to improve outcomes for cancer patients in the federal prison system. Cancer incidence is increasing in the incarcerated population and is the leading cause of illness-related deaths in state prisons. Incarcerated individuals are disproportionately from racial and ethnic minority groups and socio-economically disadvantaged communities, only adding to the disparities present in the prison healthcare system. Dr. Oladeru will undertake a study at the Federal Medical Center, Butner North Carolina (FMC Butner), the only facility in the Federal Bureau of Prisons that has the capacity for on-site radiotherapy, chemotherapy, and palliative care service. She aims to measure the cancer incidence and mortality at the federal prison level, characterize the utilization of radiation treatment, describe patterns of disease presentation and disparities in access to care, and develop an integrated value-based model for cancer care delivery in the federal prison system, which can be adapted to state prisons. FMC Butner will be the pilot location for a novel tele-oncology survivorship program as part of the model to provide cost-effective quality cancer care for incarcerated individuals. For this outstanding and ambitious proposal, Dr. Oladeru is being recognized as the first-ever James D. Cox Resident’s Research Award Winner.
G. Nic Rider, PhD, and Stephanie Terezakis, MD, of the University of Minnesota – Twin Cities will evaluate disparities in cancer care for patients who identify as lesbian, gay, bisexual, transgender, queer and/or questioning (LGBTQ+). Discrimination, access to health care, and a lack of knowledgeable providers are major barriers for LGBTQ+ individuals seeking care. They are also less likely to receive routine cancer screening and have elevated cancer mortality rates. Dr. Rider and Dr. Terezakis will lead this unprecedented collaboration between the Program in Human Sexuality and the Department of Radiation Oncology to assess the knowledge gap of radiation oncology providers regarding LGBTQ+ patients’ needs. The findings from their qualitative study will provide rich information about the training needs of various health care providers (e.g., resident/fellow, staff physician, nursing and clinical staff) to deliver more competent, quality care to LGBTQ+ patients with cancer. Ultimately, Dr. Rider and Dr. Terezakis will develop a larger-scale survey to be distributed to radiation oncology departments across the U.S. and will begin to create an educational framework for the radiation oncology community to help improve care for LGBTQ+ patients.
The ROI is pleased to be supporting these teams of exceptional researchers whose projects hold promise to reduce disparities and improve outcomes for all patients receiving radiation therapy. Congratulations to the Improving Diversity and Inclusion in Radiation Oncology Award Winners!