Racial and ethnic diversity of National Comprehensive Cancer Network (NCCN) committee members.

Abstract

81 Background: Racial and ethnic disparities are pervasive in cancer care including within the workforce and in leadership. A diverse workforce can increase patient satisfaction, treatment adherence, and improve optimal care in underserved populations. NCCN committees set the standard of care for cancer diagnosis, treatment, and survivorship, but little is known about the diversity of committee members. Methods: All NCCN organ-specific treatment guidelines from 2022 were reviewed; demographics including degree and leadership role were documented. Photographs were collected via online search and race, ethnicity, and gender were determined using a combination of facial recognition software and manual review. Academic rank and H-index were collected from professional profiles and Scopus, respectively. Multivariate analysis (MVA) assessed diversity of committees of the deadliest cancers in Black and Hispanic patients (breast, cervical, colon, gastric, gastrointestinal, hepatobiliary, multiple myeloma, non-small cell lung, pancreatic, prostate, rectal, small cell lung, and uterine cancers). Results: 1,172 unique members were found, representing 62 NCCN committees (median: 33.5 members; range: 24-40). Photographs could not be identified for 3, leaving 1,169 as the final sample. NCCN members were 74% White, 24% Asian, 2% Black, and 3% Hispanic. Members were mostly male (62%) and senior faculty (71%). Women were more likely to be junior faculty (25% vs 37% men, p<0.001) with lower median H-Index (20 vs 30 men, p<0.001). Less than half of committees (42%) had at least 1 Black member; most (76%) had at least 1 Hispanic member. The majority (82%) had at least 1 Black or Hispanic member. Of 63 Chairs, most were White (81%) and the remainder were Asian (19%). Of 59 Vice Chairs, 80% were White, 14% were Asian, and 7% were Black. There were no identified Hispanic committee Chairs or Vice Chairs. Committees for the deadliest cancers in Black and Hispanic patients were no more likely to have a respective Black (OR=1.25, 95%CI 0.58-2.71, p=NS) or Hispanic (OR=1.08, 95%CI 0.59-1.97, p=NS) committee member. On MVA, being female (OR=1.27; 95%CI: 1.01-1.58; p=0.038) and having a higher H-index (16-30: OR=1.41; 95%CI: 1.03-1.94; p=0.033; >30: OR=1.83; 95%CI: 1.32-2.55; p<0.001) were associated with increased odds of serving on a committee of a cancer deadliest in Black and Hispanic patients; neither race nor ethnicity increased the odds of serving on these committees. Conclusions: NCCN committee members in 2022 were predominantly White and Asian, with few Chair positions held by Black or Hispanic members. Less than half of committees had any Black member and committees providing guidelines for cancers with high mortality rates in Black and Hispanic patients were no more likely to have diverse members. Future efforts should focus on both diversifying the physician workforce and within leadership positions in oncology.