Every cancer center seeking to obtain (or keep) an NCI designation will soon have to present a plan for increasing the diversity of their faculty and workforce.
The institute’s sought-after core grant, also known as the Cancer Center Support Grant, now includes a component called the “Plan to Enhance Diversity.”
When applying for core grants, centers submit a budget request for each funded component of the CCSG, including developmental funds, resource management, and community outreach and engagement.
Recently, NCI announced a dedicated budget for the new diversity program, which means designated cancer centers will be able to grow their diversity, equity, and inclusion programs with CCSG funds.
The CCSG Funding Opportunity Announcement containing the new component on diversity was published Oct. 12 and takes effect with the next cycle of applications in January.
“The [Funding Opportunity Announcement] lists multiple efforts that NCI will support with CCSG funding. We expect to offer new dollars to centers for this component,” Henry Ciolino, director of NCI’s Office of Cancer Centers, said to The Cancer Letter. “I think that it speaks to the importance with which NCI regards diversity, that it has instituted major efforts both internally and with its flagship extramural program.”
It is important to note that this new CCSG component complements the existing community outreach and engagement requirement—which focuses on disparities in cancer patient populations—by addressing well-documented disparities within the oncology workforce (The Cancer Letter, Oct. 9, 2020; June 25, July 2, Nov. 5, 2021).
In response, directors and associate directors in charge of DEI programs have formed the Cancer Center DEI Network, a peer support consortium that is designed to help administrative teams share best practices for diverse recruitment, craft metrics for tracking and reporting progress, and identify common issues and challenges.
The effort is founded by Christopher Li and Wendy Law at Fred Hutchinson Cancer Research Center.
Li is DEI associate director at the Fred Hutch/University of Washington Cancer Consortium, a professor in the Public Health Sciences Division, and faculty director of the Office of DEI.
Law is the associate director of administration at the Fred Hutch/University of Washington Cancer Consortium and executive director of consortium programs.
“There is an opportunity for us at the cancer centers who are in the weeds to provide some feedback to NCI about how these efforts are going and how we might work collaboratively, and what resources are needed to do this work,” Law said to The Cancer Letter. “I think we’re grateful that the NCI is open to hearing the recommendations.”
The first virtual meeting for the network, which took place in October, was attended by about 30 cancer centers. As of this writing, there are 71 NCI-designated cancer centers, and of that number, 51 have comprehensive designation.
“I can say on a weekly basis we add more [network members],” Li said. “It’s probably about 40 centers and maybe 50 or 60 individuals, because some institutions have more than one person who’s interested in participating.
“We’ve had two meetings so far, and after each meeting, we’ve seemed to get a bolus of new people who are interested in joining, as people hear about this and connect with other colleagues. Again, I think a lot of cancer centers are just in the early stages of even figuring out how they’re going to approach this.”
A conversation with Li and Law appears here.
Associate directors of administration at cancer centers have been “very supportive” of the new CCSG component, NCI’s Ciolino said.
“We really appreciate their response,” Ciolino said. “The staff of the Office of Cancer Centers looks forward to robust discussions at the next Cancer Centers Administrators Forum in March regarding diversity efforts and the role the DEI Network can play.”
NCI’s Plan to Enhance Diversity
The new CCSG component will require “long-term commitment” from institutions in order to achieve diversity of membership and leadership in the nation’s premier academic centers, NCI officials say.
The latest version of the NCI CCSG Funding Opportunity Announcement contains the following language:
NIH and NCI are committed to ensuring that all Americans share equally in the medical advances that result from cancer research, and that current disparities in the burden of cancer are reduced or eliminated (NOT-OD-20-031).
Diversity creates stronger cancer science and is a critical step in reducing the burden of cancer for an increasingly diverse America. Therefore, the membership and leadership of NCI-designated centers ideally reflect, to the extent possible, the population that the NCI Cancer Centers Program serves—the nation.
Each center may also have special opportunities within its catchment area to enhance the diversity of its staff, membership and leadership.
NCI recognizes that achieving diversity of membership and leadership of centers will require a long-term commitment on the part of the center, and the center should be evaluated on the efforts undertaken, and the progress made, along the pathway to achieving a membership and leadership that reflects the nation’s diversity.
The new FOA provision establishes prerogatives for how funds should be used and provides guidance for DEI programs to align with NCI’s priorities. In summary, the guidelines implement mandates on:
- Recruitment of diverse and underrepresented personnel at all levels,
- Creation of leadership training initiatives and career advancement infrastructures,
- Funding for diverse faculty, and cross-department integration of diversity efforts, and
- Establishment of criteria for monitoring and evaluating progress of diversity programs.
While the guidelines focus on cancer center leadership, faculty, and advisory boards, centers are encouraged to also report other diversity-related efforts in their core grant applications.
“If a center has instituted efforts to diversify in other ways—including patients—we encourage them to include that in their next CCSG application,” Ciolino said. “I think reviewers will highly regard any effort to enhance diversity.”
A recent U.S. News & World Report study found that the vast majority of hospitals in the United States, including many academic health systems, treat patient populations that are disproportionately white (The Cancer Letter, July 30, 2021). Will NCI consider expanding the plan to include efforts that are geared toward increasing access for minority patients?
“As for all CCSG components, the Office of Cancer Centers will carefully note over the three-year lifespan of the new FOA what centers present in their applications and what reviewers ask and value in their peer-evaluation,” Ciolino said. “In that way, we will be able to expand NCI’s expectations of center efforts in a thoughtful and reasonable way.”
If a center has instituted efforts to diversify in other ways—including patients—we encourage them to include that in their next CCSG application. I think reviewers will highly regard any effort to enhance diversity.
Henry Ciolino
Cancer center administrators should note that NCI doesn’t expect the evaluation of the Plan to Enhance Diversity to be based on what a center looks like on site visit day.
“There are no boxes to check or percentages to meet—we don’t want centers to push junior faculty into leadership roles at a time when they should be focused on their research,” Ciolino said. “The goal of the component is for centers to plan how they will enhance diversity going forward—what infrastructure they will establish, what metrics they will monitor. At this point, it’s the effort that is the important thing.”
The DEI Network is shaping up as an incubator and convener for these efforts to create frameworks and metrics, Fred Hutch’s Li said.
“We did some brainstorming around what were the topics that people most wanted to start with or to discuss. And that was the number one priority,” Li said. “The second most important topic to people was around faculty recruitment. Our December meeting will focus on that topic.
“I’ve definitely appreciated The Cancer Letter’s emphasis on this topic throughout this past year in particular. I think that’s been really helpful in pushing the ball forward in many respects.”
Institutions interested in joining the Cancer Center DEI Network can reach the coordinators at cancerconsortium@fredhutch.org
This story is part of a reporting fellowship on health care performance sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.
