Strategies to Improve Access to Cancer Care

Building a Resilient Cancer Care Ecosystem: Andhra Pradesh Roadmap & the 3A Framework Cancer remains a critical public health challenge in India, with early detection and timely treatment being key to improving outcomes. As a contributor to the Andhra Pradesh Comprehensive Cancer Care Roadmap, I have seen how a structured, multi-stakeholder approach can transform cancer care. Our focus has been on prevention, early diagnosis, and equitable treatment access. The ICMR Report on Cancer Care in India highlights key gaps and opportunities: Over 2.1 lakh new cancer cases are reported annually in Uttar Pradesh alone. Limited diagnostic infrastructure in district hospitals and PHCs. Need for trained healthcare workers to improve early detection. ICMR’s initiative to accelerate district-level cancer screening, using ASHAs for home-based screenings. Integration of AI and telemedicine for early diagnosis. Applying the 3A Framework to Strengthen Cancer Care Accessibility: Bringing Care Closer to the People - Establishing district-level cancer centers to reduce patient burden. - Expanding telemedicine and AI-driven diagnostics for rural access. - Training PHC staff and ASHAs for early screening and referrals. Affordability: Ensuring Financial Protection - Leveraging Ayushman Bharat & Aarogyasri for cost coverage. - Strengthening PPPs for affordable treatment & drug subsidies. - Expanding free screening programs for early detection. Accountability: Strengthening Governance & Data-Driven Decision-Making - Implementing real-time cancer registries for better planning. - Conducting periodic impact assessments of care initiatives. - Running public awareness campaigns (anti-tobacco drives, HPV vaccination). The Way Forward The Andhra Pradesh model is creating a frugal yet robust healthcare system, ensuring every citizen has access to quality cancer care. Scaling this approach across India, backed by ICMR’s insights, can significantly improve early intervention, affordability, and accountability.  What are your thoughts on strengthening cancer care infrastructure across India? Let’s collaborate for a stronger, more accessible healthcare system. #CancerCare #PublicHealth #ICMR #HealthcareInnovation #3AFramework #AndhraPradesh #DigitalHealth #iimlucknow #healthcare #ayushmanbharat #healthcareleadership

Honored to share that our latest work is out today in the American Society of Clinical Oncology (ASCO) Educational Book — the peer-reviewed companion to the ASCO Annual Meeting and one of oncology’s most widely read sources for practice-shaping scholarship. 🌎 🌍 “Tech That Scales: A Practical Framework for AI-Enabled Cancer Care in Low- and Middle-Income Countries and Underserved US Counties.” The disparity is stark: 5-year survival for common cancers lags 20–40 percentage points behind high-income benchmarks in LMICs. In the United States, 51% of counties have no active cancer trials and no oncologist. The gap isn’t the absence of effective interventions; it’s workforce shortages, fragmented referral pathways, and loss to follow-up. In this paper, we move beyond algorithmic accuracy to deployability. Four complementary technology layers, organized around a hub-and-spoke operating model oncology leaders can actually launch: – AI-supported screening and triage (HPV self-collection + AI-assisted visual evaluation) – Project ECHO telementoring for workforce capacity – ePRO remote symptom monitoring for continuity between visits – AI-powered clinical trial prescreening hubs for access to investigational therapy The paper delivers a 90-day implementation checklist, staffing models, QA frameworks, equity and bias monitoring metrics, and a program outcomes dashboard built for oncology leaders ready to move beyond pilots toward durable, monitored deployment. Deep gratitude to my co-authors: Partha Basu, MD, PhD and Eric Lucas, MD (IARC - International Agency for Research on Cancer / World Health Organization/World Health Organization), Connor Yost, MD (Creighton University School of Medicine), and Dr. Sanjeev Arora MD — founder of Project ECHO and one of the most consequential figures in global capacity-building in medicine. Open access: https://lnkd.in/e_qkfKz2 #ASCO26 #HealthEquity #GlobalOncology #AIinHealthcare #ProjectECHO #CancerCare #prescreeninghubs St. Luke's University Health Network | Massive Bio | American Cancer Society

Whole-Person Navigation: The Future of Cancer Care (Conclusion of a 9-part series inspired by the 2023 CA Journal umbrella review on patient navigation) Over the past several weeks, we explored what over 60 studies have proven — patient navigation works. But not all navigation is created equal. The evidence is clear: the future of cancer care lies in whole-person navigation that adapts to each patient’s unique needs. 💡 Research insight: Cancer care is complex, but the barriers patients face are remarkably consistent — and addressable. From the evidence, nine pillars of effective navigation emerge: • Education empowers patients with clarity and confidence to make informed decisions • Emotional support reduces distress, strengthens adherence, and improves outcomes • Advocacy challenges systemic obstacles that delay or deny care • Symptom management prevents crises and keeps treatment on schedule • Language and cultural alignment build understanding and trust between patients and providers • Logistical coordination ensures transportation, scheduling, and communication stay on track • Financial navigation reduces the hidden costs that derail treatment and devastate families • Data visibility helps health systems identify where patients fall through cracks — and close them • Care coordination unites everyone involved in the patient’s journey, from hospital to home While these pillars form the foundation of effective navigation, success depends on how they’re applied — tailored to each patient’s unique needs, circumstances, and preferences. A single mother balancing treatment and childcare needs very different support than a senior on a fixed income or a patient managing care in a second language. The future of navigation isn’t one-size-fits-all; it’s precision support, guided by evidence and powered by empathy. We Are Here built these evidence-based practices into a single, scalable platform for cancer care teams. By addressing the full spectrum of non-clinical barriers — financial, emotional, logistical, and cultural — in ways that adapt to each individual, we help patients stay engaged, complete treatment, and reclaim control. Providers benefit, too: fewer cancellations, stronger outcomes, protected revenue, and actionable data that guide smarter system design. Why it matters: Whole-person navigation isn’t just patient-centered — it’s system-strengthening. It transforms navigation from a series of disconnected interventions into a coordinated, measurable framework for delivering equitable care at scale — one that meets patients where they are, every time. 🤔 Closing thought: The future of oncology isn’t only about developing new therapies. It’s about ensuring that every patient can access, understand, and complete the care that already exists. Whole-person navigation — personalized, evidence-based, and compassionate — is how we get there. 🙏 Thank you for following along.

I interviewed an oncologist who says that remote second opinions are closing the disparity gap in rural cancer care. Yousuf Zafar, MD, MHS joined me to discuss why geography should not determine survival. Patients in rural and socioeconomically underprivileged areas often face later diagnoses, limited access to clinical trials, and overwhelmed local oncologists who struggle to keep up with the rapid pace of cancer research. But remote second opinions are changing the equation. Dr. Zafar shared a case where a rural patient with kidney cancer was receiving outdated care. A remote review by an NCI-designated specialist not only updated the treatment plan to the current standard but also identified a clinical trial nearby that the local oncologist didn't know existed. The local doctor was relieved, not defensive, saying the review "could not have come at a better time." This collaborative model scales expertise without requiring patients to drive four hours for an appointment. For community oncologists feeling isolated, Dr. Zafar suggests: Connecting with academic centers for remote tumor boards. Checking if patients have employee benefits that cover expert remote opinions at no cost. As rural hospitals close and the oncologist shortage grows, we cannot just hope for more doctors to move to the countryside. We must use technology to bring the expertise to the patient. 🎙️ Listen to "Remote second opinions for equitable cancer care" on The Podcast by KevinMD. (Link in the comments ⬇️) #KevinMD #Oncology #RuralHealth #Telemedicine #HealthEquity #CancerCare #DigitalHealth

Advancing Digital Health Innovation in Oncology: Priorities for High-Value Digital Transformation in Cancer Care Although health care delivery is becoming increasingly digitized, driven by the pursuit of improved access, equity, efficiency, and effectiveness, progress does not appear to be equally distributed across domains. Oncology is renowned for leading innovation; digital pathology, digital radiology, real-world data, next-generation sequencing, patient-reported outcomes, and precision approaches driven by complex data and biomarkers are hallmarks of the field. However, remote patient monitoring, decentralized approaches to care and research, “hospital at home,” and machine learning techniques have yet to be broadly deployed to improve cancer care. In response, the Digital Medicine Society and Moffitt Cancer Center convened a multistakeholder roundtable discussion to identify where digital innovation is lagging in oncology. It reports that this lag is most likely attributed to poor articulation of the challenges in cancer care and research best suited to digital solutions, lack of incentives and support, and missing standardized infrastructure to implement digital innovations. It concludes with suggestions for actions needed to bring the promise of digitization to cancer care to improve lives. Persistent challenges in oncology that are highly suited for effective digital solutions exist in the following topical areas: 1. Research and development 1.1. Improve end point measurement to identify unmet clinical need 1.2. Insufficient QoL measurement – use digital reach out and engagement 1.3. Scientific methods in HTA for digital 2. Clinical care 2.1. Operational inefficiency – automate, augment and coordinate to redeploy funds into direct care 2.2. Implementation barriers due to poorly implemented strategies to date 2.3. Constrained capacity due to insufficient and ineffective digital support for workforce 3. Care personalization and coordination 3.1. Data integration – heterogenous data cannot be fused into meaningful, patient-centric uses 3.2. Data governance – increase data liquidity through rapid, seamless, and transparent sharing of data for personalized care 3.3. Inclusion - capture data on populations who have been previously invisible 4. Payer policy and reimbursement 4.1. Financial toxicity 4.2. Payer innovation – favor value-based care with digital solutions 5. Engagement and education Patel S, Goldsack JC, Cordovano G, et al. Advancing Digital Health Innovation in Oncology: Priorities for High-Value Digital Transformation in Cancer Care. J Med Internet Res 2023;25:e43404. doi: 10.2196/43404 #oncology #digitalhealth #ai #data #datagovernance #datastandards #cancercare #healthinnovation #equityandinclusion

If the United States closes its access gaps in 2026, cervical cancer could become one of the country's most preventable cancers. This is Part 4 of my #cervicalcancerawarenessmonth country series: #unitedstates The US has world-class medical technology & some of the strongest clinical guidelines for cervical cancer prevention. Yet thousands of women are still diagnosed every year. Because having good guidelines isn't the same as having access. 📌 A decade ago (2012-2015), the gaps were already visible.. > Screening coverage was strong among insured women but inconsistent among low-income & minority communities. > HPV vaccination lagged amid hesitation. Black, Hispanic, Indigenous, & rural women faced higher mortality from late diagnosis. > Prevention systems were fragmented because healthcare access depended on adequate insurance coverage. 📌 Today (2023-2025), some things have improved.. > Cervical cancer cases have declined among vaccinated age groups. HPV vaccination is recommended for ages 9-26. > Screening guidelines have shifted toward HPV testing every 5 years. 📌 But the gaps remain.. > Black & Indigenous women continue to have significantly higher mortality rates, often due to late diagnosis. > States with strong #Medicaid expansion show better screening rates than states without. Rural counties face increasing closures of women's health clinics. 📌 What worked.. > National cancer-prevention campaigns by CDC, ACS, & NIH. School-based educational efforts to normalize HPV vaccination. > HPV self-sampling pilots in research studies. Community-based programs addressing stigma & misinformation. >  Consistent messaging that HPV is common & not linked to shame. 📌 What needs to change in 2026.. > Screening can't depend on insurance or proximity, and self-sampling must go mainstream (shout-out to Teal Health) > Indigenous, rural, & low-income communities need culturally informed outreach, & the country needs nationwide consistency over state-by-state fragmentation. Here's the uncomfortable truth about the US: The technology, guidelines, & research are world-class. Yet a woman in rural Mississippi & one in Manhattan have vastly different odds of survival. Why? Because we've treated prevention as the finish line when it's only the starting point. A positive result with no gynecologist nearby, clinics closing, & no insurance for follow-up isn't prevention. It's a diagnosis without a solution. At Amplexd Therapeutics, we're asking a different question: what if treatment didn't require a specialist, a surgical suite, or a major medical center? Our self-administered suppositories for low-grade dysplasia & portable photodynamic therapy for higher-grade precancers in development are designed for exactly this reality. Treatment that travels to women, not the other way around. What would it look like if every woman in America had the same chance at prevention AND treatment? #hpvvaccination #womenshealth #healthequity

‼️ 🌟 Artificial Intelligence & Cancer Health Equity 🌟 ⚖️ My co-authors (Kingsley I. Ndoh, Darlington Akogo, Hermano Alexandre Lima Rocha, Sergio Juacaba) and I are pleased to share our latest publication in *Current Oncology Reports: Artificial Intelligence and Cancer Health Equity. This paper explores the potential of AI technologies in cancer diagnosis, treatment, and patient care—while critically examining the risks of perpetuating disparities if we don’t center equity in its design, development and deployment. The promise of AI and advanced technologies in oncology is undeniable. The stark reality is that biases in training data, unequal access to technology and digital health tools, and systemic barriers may widen cancer disparities rather than close them. That’s also why it’s crucial to #spotlight organizations committed to building inclusive technologies, digital health, consumer health tools and AI solutions to address cancer care ethically and equitably. Our paper highlights leaders in this space, including: CancerIQ – Empowering healthcare providers with AI-driven risk assessment tools for early cancer detection and prevention Rede ICC Saúde / Ceará Cancer Institute – Integrating AI into oncology care to improve access in Brazil COTA, Inc. – Using real-world data to uncover and address cancer care disparities Flatiron Health – Harnessing real-world data and AI to drive precision oncology and ensure that insights from cancer research benefit all populations Freenome – Advancing early cancer detection through AI-powered multi-omics Hologic, Inc. – Advancing women's health with AI-powered breast cancer screening solutions designed for equitable access Hurone AI – Bringing AI-driven oncology solutions to underserved communities globally minoHealth AI Labs – Leveraging AI to improve cancer diagnostics and clinical decision support in Africa Patient Discovery – Using AI and patient-reported data to personalize care and reduce barriers for diverse cancer patients Vectorgram Health – Enhancing cancer diagnostics and care in sub-Saharan Africa These are just a few of the #trailblazers ensuring that advanced technologies in cancer care does not leave anyone behind. THANK YOU! Our call to action? Technology and digital health tools must be built for everyone. That means inclusive and diverse datasets, ethical frameworks, and policies that prioritize equity at every stage of AI development. Read the full paper here: #AI #CancerCare #DigitalHealth #HealthEquity #ArtificialIntelligence #PrecisionMedicine #Oncology #MachineLearning #DiversityInAI

Equity in cancer care is not a trend or an item on a checklist. It is a value that underpins every aspect of our work. But achieving this vision requires more than ambition, it demands a commitment to equity, collaboration, and bold action. Now more than ever, there is an opportunity for public-private partnerships to accelerate progress against cancer.   I recently had the distinct privilege of collaborating on a piece in U.S. News & World Report alongside esteemed peers, where we articulated a series of high-impact executive actions the new U.S. administration can take to drive progress against cancer, here: https://lnkd.in/eCxcPcDY   Our recommendations encompass actionable strategies, including expanding telehealth – particularly in underserved rural areas – to make health care more accessible, and increasing clinical trial participation through decentralized designs and AI-driven monitoring, all of which can help ensure that more patients are receiving the best available care. We also emphasize the need for renewed support for pediatric cancer research, removing financial barriers to screenings, and strengthening resources for caregivers.   With decisive action and collaboration across government, industry, and healthcare, we can create a future where cancer is no longer the second leading cause of death in the United States.   Thank you Karen Knudsen MBA PhD, Amy Abernethy, Michael Pellini, Norman Sharpless, Esther Krofah, David Shulkin, Dee Anna Smith, and David Fredrickson, for your dedication to a future that is better for patients, families and our society.

Important research just published in the Journal of Clinical Pathways and it shines a light on some very concerning trends for anyone facing a cancer diagnosis. But the great news is there are common sense solutions we should all be advocating for if we want the best for our community. Our partners Florida Cancer Specialists & Research Institute in collaboration with Avalere Health conducted a national survey of oncology providers and the findings are striking: 📊 29% of prior authorizations for physician-administered drugs are denied on first submission 📊 80% of oncologists report they “never,” “rarely,” or “sometimes” speak with an actual oncologist during peer-to-peer reviews 📊 Nearly 60% of respondents reported average treatment delays of 1–2 weeks; 20% reported 3–4 week delays 📊 52% of oncologists skip the medical exception process entirely — not because they’ve given up, but because their patient’s disease progression will not wait The paper’s conclusion is a common sense call to action for policymakers: end fail-first step therapy in oncology, require oncologist-led reviews, enforce timely decision windows, and modernize prior auth infrastructure. Cancer treatment decisions belong to patients and their care teams. Full stop. Thank you to Lucio N. Gordan, MD, Kiana Mehring, David T. Wenk, M.D., Josh Eaves, Ryan Ciarrocchi, and the entire FCS team for the effort and rigor it takes to put this data into the peer-reviewed literature. This is exactly the kind of advocacy our patients need, and the community oncology ecosystem is stronger because of your leadership. Read the full paper in the Journal of Clinical Pathways: https://lnkd.in/g3A9U4YH #PatientsFirst #CommunityOncology #PatientAccess #PriorAuthorization #OncologyPolicy #HealthcareReform #FCS #USOncology #CancerCare

Together with the former Minister of Health, Prof. Isaac Adewole; Prof. Avram Denburg of SickKids Canada; and my excellent and superb supervisor, Prof. Beverley Essue, we just published a framework that could support improved access to childhood cancer medicines in Nigeria (and similar settings) through the Global Platform for Access to Childhood Cancer Medicines. This Platform launched by World Health Organization and St. Jude Children's Research Hospital offers hope for millions of children living with cancer in low-income settings. However, countries like Nigeria are yet to access the platform due to, amongst others, the lack of an implementation framework. Based on our findings, our proposed framework emphasizes a collaborative, partner-driven approach that leverages existing healthcare structures while promoting capacity strengthening at primary care levels. There is also the need to balance strategic planning with actionable interventions, active engagement with local experts and ensuring that efforts translate into tangible improvements in medicine accessibility for children in need. The article is published in PLOS Global Public Health and is freely accessible to all HERE: https://lnkd.in/gm6R4Gtv #Cancer #GlobalHealth #Nigeria #PublicHealth #HealthPolicy #PLOSGPH #OpenScience