Dr Randall on Addressing Disparities in Access to Specialized Sarcoma Care

“The best way to address the access [issue] is to make sure that we raise awareness [so] that individuals who are not a part of this network of network of providers, this team of sarcoma specialists, can refer patients to those [specialized] centers and not try to take it on themselves.”

R. Lor Randall, MD, FACS, the David Linn Endowed Chair for Orthopaedic Surgery, and professor and chair of the Department of Orthopaedic Surgery at the University of California, Davis Comprehensive Cancer Center, discussed disparities in global access to care for patients with sarcoma.

Sarcomas account for approximately 1% of adult malignancies but are more common in pediatric patients, occurring at a rate of approximately 15%. This disease poses a challenging diagnostic process; there are more than 70 subtypes that require various treatment approaches, including surgery and systemic and radiation therapy.

Diagnostic delays and other factors often cause patients to need to be referred to a specialized sarcoma center. However, being referred to the specialized center after inappropriate prior treatment can significantly impact subsequent treatment and prognosis.

Randall noted that access to quality treatment for patients with sarcoma varies between countries. Factors that can affect access to care include the overall resources of the country, the presence of a national health system, and the fragmentation of health care resources, he added.

Findings from a 2024 survey published in Bone & Joint Open showed that 40% of respondents from 47 countries (n = 192) reported that the majority of patients with sarcoma were treated in a specialized center. Thirty-one percent of respondents reported having access to proton therapy and 82% reported having access to all possible reconstruction methods. Compromise of ideal surgical management due to prior treatment was reported at a rate of 40% and financial constraints occurred at a rate of 17%.

To help address these disparities, it is vital to raise awareness among clinicians outside of the network of sarcoma specialists, Randall explained. This enables patients to be referred to sarcoma specialists in a timely manner where they can receive specialized care, he concluded.