• World Cancer Day: Making a commitment to close the cancer care gap

The Union for International Cancer Control (UICC) recognizes World Cancer Day annually on February 4. The UICC's 2024 theme for World Cancer Day is "Close the Care Gap." The care gap is the gap between people who can obtain healthcare related to the prevention, early detection, diagnosis and treatment of cancer and those who cannot.

The factors that create this gap include income, education and geographical location barriers. Discrimination based on ethnicity, race, gender, sexual orientation, age, disability and lifestyle can also be a barrier. Some people are also more likely to be exposed to factors that increase cancer risk, such as environmental hazards, unhealthy diet and tobacco.

Mayo Clinic joins the UICC in breaking down barriers that stand in the way of cancer care. In this Q&A, Rick Bold, M.D., site deputy director for Mayo Clinic Comprehensive Cancer Center in Arizona, discusses Mayo Clinic's commitment to closing the cancer care gap:

What does World Cancer Day mean to Mayo Clinic?

It means understanding the gaps in our cancer care and our cancer outcomes. It means recognizing those gaps by intentionally trying to close and eliminate them. There are different ways to define the gap; it may be related to the incidence of cancer, it may be related to the outcomes of cancer, and it may be related to access to cancer care. Each of these is a different gap that affects how people cope with cancer, how people survive cancer, and how people are diagnosed with cancer. We should strive to close and eliminate each of these gaps.

What is Mayo Clinic doing to help close the cancer care gap?

Cancer is not just one disease. For example, breast cancer is different for each person. Understanding why breast cancer developed at an individualized level — personalized or precision medicine — helps us determine the proper treatment for that patient and leads to better outcomes. Maybe a woman's genes caused cancer to develop. Perhaps it's where she lived — her environmental history or what she ate. We're doing studies reaching out to women across different communities, ethnic backgrounds and age groups to understand how breast cancer risk is determined. If every person is different, we need to understand that their cancer is different based on who they are. That's one effort that's helping to close the cancer care gap.

Another effort to close the gap is improving access to screening. Cancer screening is one of the most effective tools to reduce the burden of cancer in our communities. However, only some people have access to screening. Mayo Clinic is asking: How can we help everyone get access? How can we make screening easier? For example, can we detect colon cancer with a blood test instead of a colonoscopy? Can we detect it with a stool sample collected in a person's home without time away from work or family or disrupting intestinal function by drinking a solution to cleanse the colon for a colonoscopy? Mayo Clinic is researching cancer screening tools that can be made available to more people conveniently at a lower cost. These efforts can help us close the gap by detecting more cancers at their earliest stage, which is when cures happen.

Mayo Clinic is also using technology to close the gap. One example of this is proton beam therapy for radiation. Mayo Clinic has two proton therapy units, one in Scottsdale, Arizona, and one in Rochester, Minnesota. We've studied how to deliver proton beam therapy in a way that improves patient outcomes. Some people can't take the time to get radiation, which may last weeks or months. Using proton beam therapy, we can shorten treatment time, broadening access by making it more convenient for people to get treatment in a minimally disruptive way.

What is Mayo Clinic doing to reach out to underserved and rural communities facing cancer care barriers?

Mayo Clinic is developing cancer screening techniques that can be implemented internationally while recognizing that even in the U.S., not everybody has a hospital or a cancer center nearby. Many people are geographically isolated from healthcare or may lack insurance that pays for screening. We're trying to identify methods that could detect a variety of cancers early in a patient-friendly fashion, no matter what environment a person is living in and no matter what resources they have.

All Mayo Clinic locations see themselves as serving the community around them. We are developing strategic partnerships and relationships to elevate access to care in those communities and share our clinical expertise. This moves our care beyond the walls of our hospitals and clinics. Moving cancer care into patients' homes is becoming a national concept. We're starting to delve into that model of care. This will expand our ability to serve a broader population, not just in our local communities but nationally or internationally.

What is Mayo Clinic's goal for the future of cancer care?

The ideal goal would be to eliminate cancer or turn cancer into a disease nobody needs to worry about. That's a long-term goal, and maybe we will get there.

In the shorter term, the goal is to achieve equitable cancer care that provides the best outcomes in a way that doesn't significantly disrupt the lives of patients and their families while respecting their individuality and their role in decision-making. We want to put all those things together and then always keep working on improving outcomes.

Mayo Clinic is committed to eliminating care gaps so every patient, regardless of where they live or who they are, receives the same cancer care and experiences the same positive outcomes. Mayo Clinic is here to serve patients. That's our primary mission.

This article first published on the Mayo Clinic Comprehensive Cancer Center Blog.

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