Digital check-ins improve cancer care and reduce inequality
A study has shown that, for people living with advanced cancer, a simple, weekly remote check-in with their care team can have a significant impact on their quality of life.
The PRO-TECT trial – just published in the JCO Oncology Practice journal and supported by the Alliance Foundation Trials (AFT) non-profit research organisation – showed that this type of remote check-in can "help bridge communication gaps between patients and their treatment teams, offering a powerful way to make cancer care more effective," according to the investigators.
The study was carried out across community oncology practices in the US and compared weekly electronic symptom monitoring with standard care in almost 1,200 people being treated for advanced solid tumours. Any sudden worsening in symptoms recorded by the check-in system – delivered online or using an automated telephone system that did not require Internet access – triggered an alert to the care team.
The result? Over three months of follow-up, patients using the check-in system showed statistically significant improvements in symptom control and physical function compared to the standard care group, with improved quality-of-life outcomes overall.
Crucially, PRO-TECT found that the biggest improvements were seen among patient groups that have historically faced the greatest barriers to care, including Black patients and individuals with less formal education.
"When novel technologies are developed, there is a risk that they might leave historically underserved groups behind, widening rather than reducing health disparities," commented Victoria Blinder, a breast medical oncologist at Memorial Sloan Kettering Cancer Center (MSKCC) in the US and senior author of the study.
"Here, we see that the opposite seems to be happening," she added. "Rather than exacerbating disparities, implementation of remote symptom monitoring is bridging an important communication gap and improving healthcare access for underserved groups."
According to data published in 2024 by the American Association of Cancer Research (AACR), the overall cancer mortality rate in 2016–2020 was 18% higher in Black men and 12% higher in Black women, compared to their non-Hispanic White counterparts.
In addition, patients with cancer from all racial and ethnic minority groups had a lower five‐year relative survival compared to their non-Hispanic White counterparts between 2014 and 2020, with similar patterns observed in other medically underserved populations, such as people living in rural areas and/or in poverty.
There's also plenty of evidence that people from ethnic minorities are under-represented in clinical trials of new therapies for cancer.
In PRO-TECT, the improvement among Black patients brought their symptom control on par with White patients by the third month, while the biggest benefit was seen among patients with a high school education or less.
"By giving people a simple way to report health issues during cancer treatments, we were able to bypass common hurdles like communication gaps or clinician bias, sending patient concerns straight to the medical team for quick action, delaying emergency department visits and improving outcomes," said Allison Deal, a senior biostatistician at the UNC Lineberger Comprehensive Cancer Center, and a lead author of the paper.
The researchers said that if adopted nationwide, routine symptom check-ins "could be a game-changer for lowering healthcare disparities and ensuring every cancer patient gets the responsive care they need."
Image by Ales Krivec from Pixabay
