Key Clinical Summary

• A multisite initiative involving the Alliance for Equity in Cancer Care demonstrates that coordinated, community-engaged interventions can significantly reduce delays between cancer diagnosis and treatment initiation. 
• Across 8 national sites, implementation of standardized workflows, clinical pathways, and social determinants of health (SDOH) interventions improved treatment adherence and patient satisfaction. 
• Findings underscore the importance of integrating community partnerships and care coordination into oncology delivery models to address persistent disparities in access and outcomes.

Cancer disparities remain a major public health challenge in the US, influencing not only incidence and mortality but also access to timely, high-quality care. Underserved populations are disproportionately affected by delays in diagnosis and treatment—factors that can reduce the likelihood of curative intervention and worsen survival outcomes.

To address these gaps, the Alliance for Equity in Cancer Care—a multisite initiative supported by the Merck Foundation—was developed to promote equitable oncology care delivery. The program focuses on improving care coordination, enhancing patient-provider communication, addressing SDOH barriers, and fostering sustainable community partnerships. This research was presented at the 2026 National Comprehensive Cancer Network (NCCN) Annual Conference. 

Study Design and Methods

Alliance grantees implemented targeted, multilevel interventions aimed at reducing the time from cancer diagnosis to treatment initiation. Data were collected across participating sites on several key metrics, including:

• Diagnosis-to-treatment interval
• Treatment adherence
• Patient satisfaction
• Referrals to psychosocial and support services

A structured framework guided interventions, emphasizing 3 core domains:

• System-level workflow optimization
• Identification and mitigation of unmet SDOH needs
• Bidirectional community engagement

Key strategies included protocol standardization, development of clinical pathways, and incorporation of community-informed approaches tailored to local patient populations.

Study Findings

The initiative demonstrated meaningful improvements across multiple domains of cancer care delivery:

• Expanded patient reach: A total of 184 patient navigators supported nearly 3000 patients, with 2416 referred to psychosocial and support services, highlighting the scale and impact of navigation programs.
• Improved treatment adherence: Treatment adherence increased significantly in the most recent reporting period compared with baseline (P = .0022), suggesting that coordinated interventions can positively influence patient follow-through.
• Enhanced patient satisfaction: Mean patient satisfaction scores improved from 59.8 at baseline to 60.9 at 4 months (P = .0073), reflecting gains in patient experience and engagement.
• Diagnosis-to-treatment timing: While interventions were designed to reduce delays, logistic regression analysis found no statistically significant association between treatment adherence and time to treatment (β = –0.00809; P = .38), suggesting that adherence improvements may be mediated by additional factors beyond timing alone.

Clinical and Health System Implications

These findings highlight several important considerations for oncology care delivery:

1. Community Engagement is Central to Equity

Active involvement of patient navigators, caregivers, and community organizations enhances patient-centered care and improves alignment with local needs. This approach helps address nonclinical barriers—such as transportation, financial constraints, and health literacy—that often delay treatment initiation.

2. Workflow Standardization Improves Access

Streamlined clinical pathways and standardized protocols reduce inefficiencies and variability in care delivery, enabling more timely initiation of treatment.

3. Addressing SDOH is Essential for Reducing Disparities

Systematic identification and mitigation of SDOH barriers play a critical role in improving access and adherence, particularly among underserved populations.

4. Multilevel Collaboration Supports Sustainability

The success of the Alliance underscores the importance of coordinated efforts across health systems, community organizations, and policy stakeholders to achieve durable improvements in cancer care equity.

Broader Context

The results align with growing evidence that disparities in oncology outcomes are driven not only by biological factors but also by structural and social determinants. Delays in diagnosis and treatment remain a key contributor to worse outcomes in vulnerable populations, making interventions that shorten these intervals a priority for health systems and policymakers.

Importantly, the study demonstrates that scalable, community-informed models can be implemented across diverse settings, offering a potential blueprint for national efforts to reduce inequities in cancer care.

Conclusion

This multisite analysis from the Alliance for Equity in Cancer Care shows that coordinated, community-engaged strategies can meaningfully improve treatment adherence, patient satisfaction, and access to supportive services in oncology care. While the relationship between treatment timing and adherence warrants further investigation, the overall findings reinforce the value of integrating system-level optimization with community-driven approaches.

As oncology care continues to evolve toward value-based and equity-focused models, initiatives like this provide a practical framework for reducing disparities and improving outcomes across diverse patient populations.

Reference

Trapl ES, Cheatham C, Hammett A, et al. Reducing diagnosis-to-treatment times in cancer care: a community-engaged approach to health equity. Presented at: 2026 NCCN Annual Conference; March 27-March 29, 2026; Orlando, Florida, and virtual.