Cancer Network Proposes Screening for Health-Related Social Needs

Sept. 14, 2023
National Comprehensive Cancer Network recommendations include details on specific practice, policy, and guidelines approaches

The National Comprehensive Cancer Network (NCCN)—a nonprofit alliance of cancer centers—presented new recommendations for screening and addressing health-related social needs (HRSN) in people with cancer during a recent policy summit in Washington, D.C.

The group proposed four core measurements to be assessed in all cancer patients at least once a year, plus at every care transition point, as a critical component of care.

The working group recommendations identified the following key areas for routine screening:

  • Transportation Access
  • Housing Security
  • Access to Food
  • Financial Security

The recommendations also include details on specific practice, policy, and guidelines approaches to make sure these needs are screened in a thoughtful, educated, empathetic, and culturally sensitive way, and then addressed in similar fashion.

An NCCN publication featured comments made at the summit. “At NCCN, we know that caring for people with cancer must go beyond the clinic in order to achieve the best possible outcomes,” explained Crystal S. Denlinger, M.D., senior vice president, chief scientific officer for NCCN. “Health-Related Social Needs (HRSN)—unmet economic and social conditions that affect an individual’s ability to maintain health and well-being—must be accounted for as a standard part of multidisciplinary health care. That means adjusting within a system that was not previously developed with these needs in mind. Our recommendations call for education, advocacy, and engagement so that patients, providers, and policymakers can understand why and how to measure and address health-related social needs.”

“We asked ourselves, ‘What practice, policy, and guideline recommendations will help close the HRSN-based care gap patients face?’” added Yelak Biru, M.S.c., president and CEO of the International Myeloma Foundation. “By implementing routine screening for HRSN, intentionally integrating it into practice, and advocating for policies to make that possible, we can personalize treatment plans, extend care beyond clinics, and drive policy reforms for equitable and patient-centered healthcare. We hope these actions can redefine cancer care, making it comprehensive, accessible, and just.”

The speakers acknowledged that unaddressed health-related social needs cause unnecessary suffering across every area of health. But they also pointed out that the complexity, longevity, high costs, and logistical concerns that are frequently associated with cancer care make this disease a particularly important focus for social needs screening.

The speakers reiterated that these questions should only be asked when there are also systems in place to follow-through with potential solutions. Without action, the panel members feared that screening could increase feelings of distress, shame, and mistrust. To prevent that, the working group advocated that any screening should be followed with connections to relevant community-based organizations working to address these needs. There must also be incentives put in place, such as reimbursement and accreditation, to make sure this happens consistently and systematically.

Overall, the speakers stressed the importance of listening to every patient without making assumptions. NCCN said that implementing routine screening and standardized tools and best practices can help prevent unconscious bias from influencing care, ultimately reducing disparities in outcomes.

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