Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

How has equity in clinical cancer services been defined and measured, and why does it matter? (126598)

Brighid Scanlon 1 2 3 , Natasha Roberts 3 4 , David Wyld 1 3 , Suping Ling 5 , Kimberly Alexander 1 2 , Bernard Rachet 5
  1. Royal Brisbane and Women's Hospital, Herston, QLD, Australia
  2. Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
  3. Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
  4. Surgical, Treatment and Rehabilitation Service (STARS), Metro North Health, Brisbane, Queensland , Australia
  5. Inequalities in Cancer Outcomes Network, London School of Hygiene and Tropical Medicine, London, England

Objectives/purpose:

Significant cancer inequities disproportionately affect socio-economically disadvantaged groups. Current measures, such as screening participation and survival, highlight these disparities but rely on routinely collected data and are largely generated a posteriori, reflecting late consequences of existing inequities. Importantly, commonly reported measures are aggregate, population-level indicators, such as cancer incidence and mortality, which fall outside the scope of health services and clinicians to influence. This work summarises the current definitions and clinical measurements of inequities to inform the development of a core set of clinical cancer equity indicators.

Methods:

A comprehensive search strategy was designed following the JBI Reviewer’s Manual and PRISMA-ScR guidelines. Systematic searches were conducted across PubMed Central, CINAHL EBSCO, EMBASE, and ProQuest to identify commonly reported measures of clinical outcomes, access, and treatment quality. A total of 49 studies met the inclusion criteria for analysis.

Results:

Six studies offered definitions of equity, commonly emphasising accessible health services that support optimal health outcomes and the elimination of financial barriers. Six main exposures or populations were associated with experiencing cancer inequities: ethnic minority or migrant populations, low socio-economic status, geographic location or remoteness, experiencing mental illness, low health literacy and high comorbidities. Common clinical measures across population groups included advanced stage at diagnosis, delays to diagnosis and treatment commencement, lower treatment uptake, lower clinical trial participation, higher emergency presentations and shorter disease-free survival.

Clinical implications and future directions:

The current lack of reproducible, epidemiological data undermines cancer equity efforts as ad hoc reporting can misrepresent disparities or perpetuate the statistical invisibility of disadvantaged populations. While current measures provide valuable information, there is a critical need for standardised indicators which have been designed and evaluated as intentional measures of equity. These findings are currently being utilised to develop of a core set of actionable cancer equity indicators for clinical services.