Dr. Samuel Cykert spent decades studying why Black cancer patients with curable disease died at higher rates than white patients with identical diagnoses. His research led to ACCURE, an intervention that nearly closed that gap across multiple health systems.
“Retrospective data showing disparities five years later is too late for the patient who already died,” Cykert said. “So every patient with a cancer diagnosis went into a real-time registry built from electronic health records.”
That registry flagged missed appointments and delayed milestones immediately, giving clinical teams the chance to intervene before a patient fell through the cracks.
Dr. Samuel Cykert built accountability into the data
Cykert said the intervention required clinical teams to confront their own treatment completion numbers broken down by race, a step that initially provoked resistance.
“When a 10% gap showed up between Black and white patients, the team was asked to identify why,” Cykert said.
At one site, the team discovered a transportation barrier affecting patients from a specific area and built a solution that remains in place today. Cykert said removing blame from individual physicians and focusing on system-level change was essential to earning clinician buy-in.
“The message to clinicians was that they were idealistic, that the disparities were not happening on purpose, and that the system, not the individual physician, was what needed to change,” Cykert said.
A navigator’s relationship made the difference
Cykert said the nurse navigator role was central to the intervention’s success, functioning as far more than a scheduling resource. Navigators stayed in regular contact with patients, building trust that made honest conversations possible when barriers arose.
“Calling a patient noncompliant for missing an appointment is blaming the patient,” Cykert said. “The navigator’s job was to find out what the actual problem was and fix it.”
Cykert said that relationship allowed navigators to address issues like transportation, childcare, food insecurity, and mistrust in real time, rather than simply rescheduling missed appointments.
The numbers proved the system worked
Cykert described the results from the lung cancer portion of the study, which tracked 360 patients across five centers. Before the intervention, 80% of white patients completed treatment for curable lung cancer compared to 70% of Black patients.
“With the intervention in place, completion rates reached 96% and 95% respectively,” Cykert said.
Cykert said the results directly countered a common assumption that closing a disparity for one group requires sacrificing outcomes for another.
“When you build a system that works, it works for everyone,” Cykert said.
A blueprint other health systems can follow
Cykert said health systems and policymakers do not need a fully built infrastructure to begin closing similar gaps. He pointed to two foundational investments that can be implemented at relatively low cost.
“Start with a registry and a navigator,” Cykert said. “The programming for one cancer type can be done for less than $100,000 and maintained for around $10,000 a year.”
Cykert said the same framework of transparency, accountability, and communication that closed the lung and breast cancer treatment gap could extend to biomarker testing, an emerging area where new biological treatments are already showing signs of unequal access for patients of color.