This year’s World Cancer Day theme, “Unique by Unique,” recognized that every cancer patient’s journey is distinct. Yet as someone treating thousands of cancer patients annually across diverse communities, I’ve learned a paradox: true personalization is impossible without addressing systemic barriers that prevent patients from accessing care in the first place.
The obstacles preventing timely cancer diagnosis and treatment aren’t just medical — they’re deeply societal. We face a trust deficit rooted in historical medical abuses, practical barriers like transportation and language access, and a research gap where treatments developed without diverse populations fail underserved communities. When underrepresented groups face significantly higher cancer mortality rates and comprise only 5% of national clinical trial participants, we can’t pretend this disparity reflects biology alone.
Effective cancer care requires treating scale and personalization as complementary necessities, not opposing forces, built on three strategic foundations.
First, we must democratize access to cutting-edge clinical trials. Precision medicine depends on understanding genetic diversity, yet our research remains dangerously homogeneous. When health systems achieve meaningful diversity in clinical trials — like Northwell’s 36% participation from underrepresented communities — treatments become more effective because ethnic diversity is genetic diversity. Our therapies only work when built on inclusive science.
Second, we must reimagine care delivery to address the whole person. True personalized care means tackling transportation barriers, language needs and food insecurity that can derail even the most precisely targeted therapy. This requires multilingual staff, culturally competent navigation programs and community partnerships that understand social determinants affecting cancer outcomes.
Third, we must leverage technology to extend reach without losing human touch. Virtual clinical trials and telemedicine platforms can maintain scientific rigor while dramatically increasing access through community partnerships. When we deliver cutting-edge treatments in patients’ neighborhoods rather than forcing impossible travel choices, we’re not compromising care — we’re optimizing it.
Integrated health systems demonstrate how this works at scale. Patients diagnosed in community hospitals should immediately access the same molecular tumor boards, genetic counseling and clinical trials as those at academic medical centers. Expertise must flow seamlessly without forcing choices between staying close to home and getting world-class care.
Looking ahead, the greatest transformation will be artificial intelligence converging with community-based delivery. AI can enable same-day diagnosis and treatment planning in neighborhood settings while predicting which patients risk falling through cracks due to social determinants. But technology must serve equity — the future belongs to health systems making advanced cancer care as accessible as possible.
“Unique by Unique” isn’t just about recognizing individual differences — it’s about ensuring every unique patient can access the personalized care they deserve. When we achieve this, we don’t just improve outcomes for underserved populations; we advance the science for everyone. Research is critical, and diverse research is even more critical.
True precision medicine treats equity and excellence as inseparable.
Richard Barakat, MD, is physician-in-chief and executive director of cancer at New Hyde Park, N.Y.-based Northwell Health. He will be sharing more during a fireside chat, “Ensuring Diverse Participation and Equitable Access in Cancer Care,” on Tuesday, April 14 at 11:35 a.m. at Becker’s Oncology Executive Summit. Learn more about the event here.
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