Building equity in cancer screening through research: The Siteman Catchment CSRN Hub

To bring equity principles to research and practice of cancer screening and early detection, we will build a CSRN ACCESS Hub at Siteman Cancer Center. Improving early detection is critical to reducing the growing burden of cancer in our society and has the potential to reduce cancer health disparities. For this to happen, research must not only include groups who have traditionally been marginalized and under-represented in research, we must consider those communities in research design and conduct. Research conducted at the Siteman Catchment Hub will prioritize rigor, equity, diversity, and inclusion of under-represented populations. We represent a collaboration of Siteman Cancer Center and seven community-based healthcare systems in Missouri and Illinois. Led by an experienced multi-disciplinary team, our time-tested administrative structure engages representation from participating sites, community partners, community-based clinicians, and institutional experts in this endeavor. We draw on the deep clinical research infrastructure and supports at Siteman Cancer Center and Washington University School of Medicine, and organized our Hub into four cores: Administrative, Participant, Study Protocol, and Data. We are founded on intentional integration, engagement, and transparent communication strategies. The specific aims of our Center are: (1) Contribute to the scientific development of CSRN research including an initial Multi-Cancer Detection Vanguard study that is inclusive of diverse populations and considers health equity in its approach; (2) Recruit and retain diverse participants to CSRN studies with representation across rural and urban, income and insurance, and racial and ethnic backgrounds; and (3) Implement CSRN protocols, including diagnostic follow-up as needed. Building on our experience conducting research that includes groups traditionally under-represented in research, we propose to enroll 2000 individuals across our region into the Vanguard study, with at least 50% from rural areas and 25% from racial and ethnic groups under-represented in research, and with purposeful inclusion of low-income and under/ un-insured adults. We will work closely with community partners to support recruitment and ensure protocols are accessible to diverse individuals. The Siteman Catchment Hub has several notable strengths and innovations. First, we serve and are committed to populations that are medically underserved and under-represented in clinical research. Second, our multidisciplinary leadership team is dedicated to equity and inclusion, and has deep experience with cancer screening research and clinical trials. Third, we engage organizational partners and community partners in Hub leadership. Fourth, we have strong institutional support and infrastructure that will support the conduct of this research, access to quality data, and rigor in our approach. We need sound evidence to inform advances in cancer screening and early detection, including considering feasibility and acceptability of future implementation in diverse settings and populations. The Siteman Catchment CSRN Hub will deliver on that need.