Blue Review
A Provider Publication

November 2022

Health Equity in Cancer Prevention and Control 

Health equity presents the ideal that everyone deserves a fair shot at living their healthiest possible life. But some populations may be at a disadvantage due to social determinants of health (SDoH) – social, economic or physical conditions they experience at home, school, work and elsewhere in their neighborhoods and communities. SDoH can lead to variances in health status/distribution of health resources, tipping the scale towards health inequity. 

When it comes to cancer, everyone should have a fighting chance – equal access to education on preventive care and screening options to identify risk, find cancer early and get proper treatment and follow-up after treatment is completed. But it’s important to understand SDoH and health disparities that may affect your patients and create barriers to getting proper care.

The places where people live, learn, work and play can affect their chances of getting and dying from cancer. For example, some people may not have safe access to healthy food nearby. They may not have reliable transportation to get to the store or to make it to doctor’s appointments. They may not be aware of educational and support resources in their communities. They may have challenges with finding childcare. They may not have health insurance.

SDoH may help determine how likely a person is to be diagnosed with cancer. The Centers for Disease Control and Prevention (CDC) works to identify cancer facts, potential disparities and ways to increase awareness. Here are some examples:

  • Cigarette smoking can cause cancer almost anywhere in the body. Smoking rates are higher among people with a lower education level. For example, nearly 20% of all U.S. adults with a high school education smoke, but only about 7% of people with a four-year college degree smoke.1 At a national level, the CDC’s Office of Smoking and Health is continuously putting forth efforts to reduce deaths and prevent chronic diseases that result from smoking, including cancer.
  • Obesity is linked with a higher risk of getting at least 13 different kinds of cancers, including breast cancer. Adults living in rural counties are more likely to have obesity than adults in urban counties. This is likely due to having less access to quality grocery stores that sell healthy and affordable food options.
  • Lack of screenings for cancer as recommended can result in cancer being found at a late stage when it’s harder to treat. Those patients experiencing disparities often don’t get screened due to lack of transportation, unable to schedule time off from work or lack of accessibility to screening centers.

How You Can Help
Here are some ways you can help bridge the gap and remove barriers related to cancer care:

  • Outreach and educate members on the importance of getting all recommended cancer screenings.
  • Optimize use of telehealth services when available and appropriate for preventive care appointments.
  • Participate in shared decision making to identify the best screening and treatment options for the member. Patient navigation from outreach, education, risk reduction, detection, diagnosis, and treatment, through survivorship or end-of-life care can help reduce barriers to quality care.2
  • Assist members in scheduling appointments, such as mammograms, and ensure access to transportation.
  • Remind BCBSIL members about free non-emergency transportation services. Members can call the number on their BCBSIL member ID to confirm eligibility and availability of services.
  • For breast cancer screenings: Partner with mammogram facilities to ensure members with referrals complete their mammogram and conduct follow-up outreach to members as needed. When abnormal mammograms are detected, ensure follow up outreach to member is conducted along with assistance for follow-up care. For patients who lack health care insurance, the CDC provides an option for your patient to receive adequate cancer screening and resources through the National Breast and Cervical Cancer Early Detection Program.3
  • Identify SDoH associated with cancer screening completions. Include ICD-10Z codes for SDoH on claims submitted to BCBSIL so that we can help address barriers and connect members with available resources.

1U.S. Department of Health and Human Services. Burden of Cigarette Use in the U.S. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2021. Accessed Sept. 27, 2021, at https://www.cdc.gov/tobacco/campaign/tips/resources/data/cigarette-smoking-in-united-states.html

2Equity in Cancer Prevention and Control. Division of Cancer Prevention and Control, CDC. https://www.cdc.gov/cancer/health-equity/equity.htm

3CDC, National Breast and Cervical Cancer Early Detection Program. https://www.cdc.gov/cancer/nbccedp/

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to other third party sources or organizations are not a representation, warranty or endorsement of such organization. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.