Increasing research to address cancer care disparities in an NCI-sponsored community oncology network.

176 Background: Improving the delivery and outcomes of cancer care should be informed by research that aims to reduce disparities among underserved populations and those underrepresented in clinical studies. The NCI Community Oncology Research Program (NCORP), a community-based clinical trials network, conducts such research. In this analysis, we aimed to identify opportunities to develop a robust program of disparities-relevant cancer care delivery research (CCDR). Methods: We reviewed NCORP CCDR studies approved between August 2014-May 2022. Any study with at least one aim addressing care delivery in NIH-health disparity or underrepresented populations was deemed disparities-relevant. Studies were categorized as: primary if they were focused exclusively on cancer disparities within populations of interest; secondary if they had a disparities-related aim in a broader study; and exploratory if the aim assessed differences by race, ethnicity, income, insurance status, or practice-level characteristics. For each CCDR protocol, study and disparities-related characteristics were abstracted by two reviewers, who resolved any disagreements by discussion. Descriptive statistics are summarized. Results: Of 23 CCDR studies, a majority had at least one disparities-relevant aim: 4 primary, 3 secondary, and 10 exploratory. Studies with primary and secondary aims focused on racial/ethnic minorities, rural residents, older adults, adolescent/young adults and socioeconomically disadvantaged populations. Cancer care delivery gaps addressed by these studies included shared decision making, guideline adherence, case management, healthcare expenditures, and healthcare accessibility. Most studies focused on patients undergoing active treatment and included multilevel interventions. Only one of the disparities-relevant studies was available to non-English speaking patients. Conclusions: The inclusion of disparities-relevant aims in most of the care delivery studies is encouraging. The fact that most studies with a primary or secondary aim included an intervention demonstrates strong interest in generating evidence that will support improved cancer care delivery. Studies also addressed several distinct disparity populations across a range of care delivery gaps. These results represent opportunities for targeted network efforts to increase the disparities research portfolio and may inform strategies to optimize equitable care delivery that meets the needs of diverse cancer patient/survivor populations.