June 26, 2020

RO Corner: Diversity in Radiation Oncology

Anna M. Laucis, MD, MPhil, chief resident physician at the University of Michigan Department of Radiation Oncology.

Graphic of people holding signs

There are multiple ongoing public health crises. Our nation faces an unprecedented dilemma with the ongoing COVID-19 pandemic and concerns about racial inequities. At a time when the pandemic was already disproportionately affecting people of color, the whole world watched with shock and horror as Breonna Taylor, George Floyd, and other black individuals tragically died. These public deaths have sparked protests in every city in the U.S. and other major cities around the world.

So what does all of this mean for radiation oncology?

It is impossible to ignore these ongoing issues, and as a field we must ensure that we show strong support for diversity, equity, and inclusion in our clinical, leadership, and research environments. It is encouraging that ASTRO has established a Committee on Health Equity, Diversity, and Inclusion (CHEDI),1 and the ACR also has a Commission for Women and Diversity.2 These committees aim to advance diversity and inclusion principles within radiation oncology and radiology. At the state and institutional levels, it is also important to have committees with similar focuses and to ensure that diversity work advocates not just for gender diversity within our traditionally male-dominated fields but also for racial diversity.

As much as women are underrepresented in radiology and radiation oncology, minority ethnicities and races are woefully underrepresented. As of 2010, only 7% of practicing radiation oncologists were black and 7% were Hispanic, and only 15% of the residency applicant pool was black or Hispanic.3 In the general US population, 31% of individuals identify as black or Hispanic.4 We must be intentional about ensuring that everyone has a seat at the table to ensure that decisions are made with varied input.

In 2019, several radiation oncologists published a practical guide to increasing diversity in the radiation oncology workforce with actionable steps that residency programs can take when evaluating applicants to increase diversity.5 Particularly at a time when our field has seen an overall decrease in the number of residency applicants, it is imperative for us to take a step back to reflect upon our selection criteria for residency and ensure that a commitment to diversity is maintained or even strengthened. A diverse radiation oncology workforce will allow us to take the very best care of our diverse population of cancer patients and to support them through these challenging times.

ENDNOTES

Deville C. Updates from ASTRO’s Committee on Health Equity, Diversity, and Inclusion (CHEDI). Available at: https://astroblog.weebly.com/blog/updates-from-astros-committee-on-health-equity-diversity-and-inclusion-chedi. Accessed 9 June 2020.

ACR Commission for Women and Diversity. Available at: https://www.acr.org/Member-Resources/Commissions-Committees/Women-Diversity. Accessed 9 June 2020.

Chapman CH, Hwang WT, Deville C. Diversity based on race, ethnicity, and sex, of the US radiation oncology physician workforce. Int J Radiat Oncol Phys Bio 2013; 85(4): 912-918.

U.S. Census Bureau: Quick Facts. Available at: http://www.census.gov/quickfacts/fact/table/US/PST045217. Accessed on 15 June 2020.

Nead KT, Linos E, Vapiwala N. Increasing Diversity in Radiation Oncology: A Call to Action. Adv Radiat Oncol 2019; 4(2): 226-228.