For more than 2 decades, Don S. Dizon, MD, FACP, FASCO, has devoted his medical career to the care of women’s cancers and the sexual health of cancer survivors of all genders and sexual identities. Early in his career, Dr. Dizon founded the Center for Sexuality, Intimacy, and Fertility at Women & Infants Hospital of Rhode Island and the Sexual Health Clinic at Massachusetts General Hospital Cancer Center. In 2012, Dr. Dizon founded and was named Director of the Oncology Sexual Health Clinic at Massachusetts General Hospital Cancer Center. Currently, Dr. Dizon is Director of Women’s Cancers at Lifespan Cancer Institute, Director of Medical Oncology at Rhode Island Hospital, and Professor of Medicine and Professor of Surgery at the Warren Alpert Medical School of Brown University.
In addition to these responsibilities, this past fall, Dr. Dizon was named the inaugural Vice Chair for Diversity, Equity, Inclusion, and Professional Integrity with the Southwest Oncology Group (SWOG) Cancer Research Network, also serving as an ombudsman for SWOG members concerned about unethical professional behavior. In this new capacity, Dr. Dizon will assess potential barriers to minority participation in SWOG’s cancer clinical trials and will investigate solutions to increase diversity among SWOG’s leadership and membership.
“Creating this new position shows SWOG’s commitment to the principles of diversity, equity, and inclusion, which are already embedded in SWOG’s missions and values. We hope that our members and those who want to work with SWOG will see this position as a strength and an invitation to join us in making clinical trials more diverse and inclusive,” said Dr. Dizon.
The ASCO Post talked with Dr. Dizon about his new position and his plans for achieving a more diverse, equitable, and inclusive research workforce as well as clinical trial design to increase accessibility to quality care for all patients with cancer.
We are learning that if investigators look like the patients we are trying to recruit into clinical trials, we will be more successful.— Don S. Dizon, MD, FACP, FASCO
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Identifying Barriers to Accessing Cancer Care for Minority Patients
Please talk about your new role as Vice Chair of Diversity, Equity, Inclusion, and Professional Integrity at the SWOG Cancer Research Network. Why did you decide to take this position?
Part of the work I am doing at Brown University is to head efforts in community outreach to build a bidirectional platform to engage people with cancer, which is something I have been interested in doing ever since I saw firsthand the benefits of using social media to communicate with patients and the cancer community. It is difficult to align missions and the needs of communities, especially communities that are underrepresented in medicine, so that was part of my motivation to take this new position. The other part was to highlight the disparities in sexual and gender minority communities to identify barriers to increasing access to cancer care in that patient group.
We are still working on building a platform that can be used nationally to collect data on patients’ sexual orientation and gender identity. Doing this work was instrumental in increasing my interest in what can be done—and what should be done—on the clinical trials network level to increase diversity in cancer clinical trials. SWOG is really forward thinking in this area, and elevating the diversity, equity, and inclusion initiatives to a leadership position shows that these principles are embedded in our mission.
Broadening the Definition of ‘Diversity’
Participation in cancer clinical trials by eligible adults with cancer is less than 5%,1 and although minority racial and ethnic groups make up nearly 40% of the U.S. population, just 11% of the nearly 5,000 participants in the clinical trials of 18 new cancer drugs approved in 2020 by the U.S. Food and Drug Administration were Black or Hispanic.2 How do you plan to make SWOG’s cancer clinical trials more inclusive and increase participation by minority patient populations?
This is a challenge. What is under the purview of this new effort at SWOG encompasses both its internal and external work to ensure that our membership is diverse and that our future leaders include a diverse group of investigators. We are learning that if investigators look like the patients we are trying to recruit into clinical trials, we will be more successful.
To me, the word “diversity” is a very broad way to capture what I call the intersectionality of people; it is not just limited to race, sex, gender, or age. It includes veteran status, disabilities, and where we work and live. Diversity can include whether physicians have an academic practice or are embedded within the community. There are various ways we can see ourselves in the patients we want to help, but also in each other, and I want to bring that degree of diversity to SWOG.
Improving diversity has to be intentional. We have started a DEI (Diversity, Equity, Inclusion) champion pilot program in which individuals with an interest in increasing diversity, equity, and inclusion in research are tasked with developing a project within specific research committees focused on diversity, equity, and inclusion efforts. We have also launched a monitoring committee to put infrastructure in place to track DEI within SWOG.
Our goals are to demonstrate the diversity, equity, and inclusion principles that are at the core of our mission and to ensure these principles inform all aspects of professional development, research, advocacy, and outreach done with and on behalf of SWOG.
Providing a Safe Environment to Air Professional Grievances
Please talk about your role as ombudsman to address unethical professional behavior within SWOG.
I have been involved in SWOG for more than 5 years. Every time I attend a SWOG conference, I am impressed by the level of professionalism everyone brings to the table, including our patients, patient advocates, clinical research staff, leaders, and investigators. It is a welcoming environment. Still, people may find themselves facing issues within SWOG and not know where to take their concerns. Having a formal procedure in which any concerns can be heard and brought to a resolution is part of our welcoming efforts.
I want members and staff to know that in my role as ombudsman, I will advocate to help them achieve their objectives within the cooperative groups and help them find opportunities to become more engaged in SWOG.
DISCLOSURE: Dr. Dizon has served as a consultant for AstraZeneca, Clovis, and GSK and has received research funding from BMS and Pfizer.
REFERENCES
1. Niranjan SJ, Wenzel JA, Martin MY, et al: Perceived institutional barriers among clinical and research professionals: Minority participation in oncology clinical trials. JCO Oncol Pract 17:e666-e675, 2021.
2. U.S. Food and Drug Administration: 2020 Drug Trials Snapshots Summary Report. February 2021. Available at www.fda.gov/media/145718/download. Accessed January 6, 2022.
