Leadership at Cancer Centers Still Mostly White and Male

Pam Harrison

August 24, 2022

A survey of cancer centers across the United States that have a National Cancer Center designation from the National Cancer Institute (NCI)shows that leadership is still mostly white and male.

The survey was conducted by the Association of American Cancer Institutes and drew responses from 64 NCI-designated and 18 emerging centers.

Non-Hispanic White participants made up 79% of center directors, 82% of deputy directors, 72% of associate directors, and 72% of program leaders.

"Women were underrepresented in all leadership roles (ranging from 16% for center directors to 45% for associate directors)," the authors note.

The results show "a substantial lack of diversity in the traditional cancer center senior leadership pipeline," they add.

The study was published online July 28, 2022 in the Journal of the National Cancer Institute.

"With the rapid evolution and increasing complexity of oncology research and practice, the need for capable and diverse leaders of NCI-designated cancer centers has never been greater," lead author Caryn Lerman, PhD, director, USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, and colleagues write.

"To achieve the nation's goal to 'end cancer as we know it,' cancer centers can and should prioritize leadership development and diversity as an organization priority," they add.

Lack of Diversity at All Levels, Not Just Leadership

"The lack of diversity in the leadership pipeline for cancer centers may also reflect the underrepresentation of racial and ethnic minorities, women and gender minorities in the healthcare and biomedical workforce," the authors suggest.

Specifically, it may be attributed to disparities in the application, matriculation, and completion of professional and graduate schooling of these minorities.

For example, in 2011, African American and Hispanic individuals made up less than 8% of applicants to medical schools. This has not changed in more recent years, the authors note. "The success of senior leaders in NCI-designed cancer centers requires the development and skills deployment of collaborative leadership competencies that may not have been taught in scientific or medical training," Lerman and colleagues suggest.

Key strategies to promote leadership diversity include the selection of talented, early-stage clinicians and scientists who show an appetite and aptitude for leadership to be selected to participate in and then lead task forces or committees in programs such as strategic planning development. "These candidates would ultimately be groomed for progressively elevated leadership roles with institutional support for leadership development and coaching," they state.

Inclusion of faculty members who are underrepresented is vital, they comment.

However, they acknowledge that meeting these diversity aspirations for NCI-designed cancer centers will remain a "tremendous challenge" until the pipeline of minority and underrepresented faculty is sufficient enough to present a robust population of the applicant pool for cancer center leadership roles.

Each center's "commitment to diversity and inclusion ought to be clearly stated and key attributes of candidates can be framed in the most inclusive and culturally competent manner," the researchers write.

"Every effort should be made to place advertisements in outlets that are most likely to reach diverse groups and reach out to leaders at other institutions for recommendations [while] search firms should be similarly charged with producing a diverse slate of candidates," they suggest.

The work was supported by the National Cancer Institute.

The authors report no conflicts of interest.

J Natl Cancer Inst. Published online July 28, 2022. Full text

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